Organization
MERCY CARE MANAGEMENT, INC
Active
Other names
Mercy Care North
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY L CHARLES (PRESIDENT AND CEO)
(319) 398-6697
Entity
Organization
Contact information
Practice address
5264 COUNCIL ST NE, SUITE 100, CEDAR RAPIDS, IA 52402-2471
(319) 369-4798
Mailing address
PO BOX 786, CEDAR RAPIDS, IA 52406-0786
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0201558
—
IA
05
—
0462259
—
IA
Enumeration date
06/27/2007
Last updated
11/01/2018
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