Organization Name: | MERCY MEDICAL SERVICES |
NPI Number: | 1043251754 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRIAN K. MONSMA (EXECUTIVE NETWORK DIRECTOR) |
Mailing Address: | 501 1st Ave South Sioux City |
State: | NE US |
Postal Code: | 687761703 |
Phone Number: | 4024943064 |
Fax Number: | 4024942656 |
NPI Enumeration Date: | 06/10/2006 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |