Provider Demographics
NPI:1427093962
Name:MERCY MEDICAL CENTER-CLINTON, INC
Entity type:Organization
Organization Name:MERCY MEDICAL CENTER-CLINTON, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO/CNO
Authorized Official - Prefix:
Authorized Official - First Name:MELLISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-244-5608
Mailing Address - Street 1:1410 N. 4TH ST.
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-2940
Mailing Address - Country:US
Mailing Address - Phone:563-244-5555
Mailing Address - Fax:563-244-5592
Practice Address - Street 1:1410 N 4TH ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-2940
Practice Address - Country:US
Practice Address - Phone:563-244-5676
Practice Address - Fax:563-244-5592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA230056H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0600809Medicaid
IA0600809Medicaid