Organization
MERCY PET SCANNER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA ROBBINS (DIRECTOR OF BILLING)
(515) 643-8672
Entity
Organization
Contact information
Practice address
411 LAUREL ST, SUITE 2310, DES MOINES, IA 50314-3017
(515) 643-5353
Mailing address
PO BOX 1771, DES MOINES, IA 50306-1771
(515) 643-5353
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255349
—
IA
01
—
33631
WELLMARK OF IOWA
IA
Enumeration date
12/12/2006
Last updated
08/22/2020
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