Provider Demographics
NPI:1215978929
Name:MERCY MEDICAL SERVICES
Entity type:Organization
Organization Name:MERCY MEDICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:M. ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANNERY-HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-279-2018
Mailing Address - Street 1:PO BOX 328
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51102-0328
Mailing Address - Country:US
Mailing Address - Phone:712-279-5830
Mailing Address - Fax:712-279-5883
Practice Address - Street 1:624 JONES ST
Practice Address - Street 2:SUITE 5400
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1924
Practice Address - Country:US
Practice Address - Phone:712-279-2510
Practice Address - Fax:712-279-2519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA07228OtherWELLMARK GROUP NUMBER
IA10025144300Medicaid
IA46357Medicare PIN