Organization
MERCY MEDICAL CENTER-CENTERVILLE
Active
Other names
Centerville Medical Clinic-Mercy
Organization subpart
No
Provider details
NPI number
Authorized official
PAM YOUNG (BUSINESS OFFICE MANAGER)
(641) 437-3413
Entity
Organization
Contact information
Practice address
19876 ST. JOSEPH'S DRIVE, CENTERVILLE, IA 52544
(641) 856-8684
Mailing address
19876 ST. JOSEPH'S DRIVE, CENTERVILLE, IA 52544
(641) 856-8684
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IB1441
PTAN
—
Enumeration date
06/11/2009
Last updated
06/09/2010
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