Organization
MERCY HEALTH SERVICES-IOWA CORP
Active
Other names
MercyOne Mason City Long Term Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARK TRAMMEL (ASST TREASURER)
(641) 428-7984
Entity
Organization
Contact information
Practice address
910 N EISENHOWER AVE, MASON CITY, IA 50401-1525
(641) 428-6944
(641) 428-6946
Mailing address
PO BOX 1159, MASON CITY, IA 50402-1159
(641) 428-6944
(641) 428-6946
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
1140
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00223750
—
IA
05
—
143410100
—
MN
01
—
2030059
PK
—
Enumeration date
11/06/2006
Last updated
10/10/2024
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