Organization
MERCY HEALTH SYSTEM CORPORATION
Active
Organization
MERCY HEALTH SYSTEM CORPORATION
Active
Parent organization
MERCY ALLIANCE INC
Other names
MERCY CLINIC NORTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
MERCY ALLIANCE INC
Authorized official
JOHN W COOK (VP/CFO)
(608) 756-6000
Entity
Organization
Contact information
Practice address
3400 DEERFIELD DRIVE, JANESVILLE, WI 53546-3557
(608) 314-3660
(608) 314-3661
Mailing address
1000 MINERAL POINT AVE, JANESVILLE, WI 53548-2940
(608) 756-6000
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
310-800
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52D02033323
CLIA
WI
Enumeration date
01/05/2012
Last updated
01/05/2012
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