Provider Demographics
NPI:1104046275
Name:MERCY SERVICES IOWA CITY, INC.
Entity type:Organization
Organization Name:MERCY SERVICES IOWA CITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BOGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-339-3540
Mailing Address - Street 1:500 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-2633
Mailing Address - Country:US
Mailing Address - Phone:319-339-3540
Mailing Address - Fax:
Practice Address - Street 1:503 3RD ST
Practice Address - Street 2:
Practice Address - City:KALONA
Practice Address - State:IA
Practice Address - Zip Code:52247-9526
Practice Address - Country:US
Practice Address - Phone:319-656-3151
Practice Address - Fax:319-656-3319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA16685Medicare PIN