| Mercy Care South | |
|
2815 Edgewood Rd Sw Cedar Rapids IA 52404-3258 | |
| (319) 369-4798 | |
| Not Available |
| Full Name | Mercy Care South |
|---|---|
| Speciality | Family Medicine |
| Location | 2815 Edgewood Rd Sw, Cedar Rapids, Iowa |
| Authorized Official Name and Position | Timothy L Charles (PRESIDENT AND CEO) |
| Authorized Official Contact | 3193986697 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Care South Po Box 786 Cedar Rapids IA 52406-0786 Ph: () - | Mercy Care South 2815 Edgewood Rd Sw Cedar Rapids IA 52404-3258 Ph: (319) 369-4798 |
| NPI Number | 1306042890 |
|---|---|
| Provider Enumeration Date | 06/22/2007 |
| Last Update Date | 11/01/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306042890 | NPI | - | NPPES |
| 0794263 | Medicaid | IA | |
| 0794255 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
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