Basic Information
| Provider Information | |||||||||
| NPI: | 1760426431 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BAUM HARMON MERCY HOSPITAL | ||||||||
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| OtherOrganizationName: | BAUM HARMON MERCY HOSPITAL ER | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 621 S ILLINOIS AVE | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | MASON CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 504015489 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6414283041 | ||||||||
| FaxNumber: | 6414283059 | ||||||||
| Practice Location | |||||||||
| Address1: | 255 NORTH WELCH AVE | ||||||||
| Address2: | |||||||||
| City: | PRIMGHAR | ||||||||
| State: | IA | ||||||||
| PostalCode: | 51245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7129572300 | ||||||||
| FaxNumber: | 7129570300 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2006 | ||||||||
| LastUpdateDate: | 12/30/2016 | ||||||||
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| AuthorizedOfficialLastName: | SHILLING | ||||||||
| AuthorizedOfficialFirstName: | ANGIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | COO/CEO | ||||||||
| AuthorizedOfficialTelephone: | 7129572300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363LF0000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 207R00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207Q00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.