Organization
MERCY MEDICAL CENTER
Active
Parent organization
MERCY MEDICAL CENTER
Other names
Mercy Home Medical Equipment
Organization subpart
Yes
Provider details
NPI number
Legal business name
MERCY MEDICAL CENTER
Authorized official
MR. TIMOTHY CHARLES (PRESIDENT AND CEO)
(319) 398-6697
Entity
Organization
Contact information
Practice address
701 10TH ST SE, CEDAR RAPIDS, IA 52403-1251
(319) 363-1308
Mailing address
701 10TH STREET SE, CEDAR RAPIDS, IA 52403
(319) 363-1308
(319) 398-6509
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
570036H
IA
332BX2000X
Oxygen Equipment & Supplies (DME)
570036H
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0295857
—
IA
01
—
47622
WELLMARK NUMBER
IA
Enumeration date
10/31/2006
Last updated
04/25/2014
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