Provider Demographics
NPI:1598786220
Name:MERCY MEDICAL CENTER-DYERSVILLE
Entity type:Organization
Organization Name:MERCY MEDICAL CENTER-DYERSVILLE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GEARHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-875-2909
Mailing Address - Street 1:1111 3RD ST SW
Mailing Address - Street 2:
Mailing Address - City:DYERSVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52040-1725
Mailing Address - Country:US
Mailing Address - Phone:563-875-7101
Mailing Address - Fax:563-589-2904
Practice Address - Street 1:1111 3RD ST SW
Practice Address - Street 2:
Practice Address - City:DYERSVILLE
Practice Address - State:IA
Practice Address - Zip Code:52040-1725
Practice Address - Country:US
Practice Address - Phone:563-875-7101
Practice Address - Fax:563-589-2904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA310181H275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0655167Medicaid
IA66154OtherBLUE CROSS
IA0655167Medicaid