Provider Demographics
NPI:1386620029
Name:MERCY HOSPITAL, IOWA CITY, IOWA
Entity type:Organization
Organization Name:MERCY HOSPITAL, IOWA CITY, IOWA
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 1:540 E JEFFERSON ST STE 305
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-2479
Mailing Address - Country:US
Mailing Address - Phone:319-358-2740
Mailing Address - Fax:319-358-2760
Practice Address - Street 1:540 E JEFFERSON ST STE 305
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2479
Practice Address - Country:US
Practice Address - Phone:319-358-2740
Practice Address - Fax:319-358-2760
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HOSPITAL, IOWA CITY, IOWA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-15
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA67181OtherBLUE CROSS BLUE SHIELD
IA0671818Medicaid
IA167181Medicare Oscar/Certification