Basic Information
| Provider Information | |||||||||
| NPI: | 1831410661 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MERCY CLINICS, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | MERCY ADEL MEDICAL CLINIC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1475 | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503051475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5159934656 | ||||||||
| FaxNumber: | 5159934532 | ||||||||
| Practice Location | |||||||||
| Address1: | 1120 GREENE ST | ||||||||
| Address2: | |||||||||
| City: | ADEL | ||||||||
| State: | IA | ||||||||
| PostalCode: | 500031712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5159934656 | ||||||||
| FaxNumber: | 5159934532 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2010 | ||||||||
| LastUpdateDate: | 04/08/2019 | ||||||||
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| AuthorizedOfficialLastName: | PHILLIPS | ||||||||
| AuthorizedOfficialFirstName: | SHARON | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF OPERATING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 5153586960 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.