Mercy Health System Corporation
Organization Active NPI Durable Medical Equipment & Medical Supplies · Edgerton, WI
NPI 1124159165 · NPPES record last updated Feb 23, 2016
Key facts
- NPI
- 1124159165
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- 310-800 (WI)
- Legal business name
- MERCY HEALTH SYSTEM CORPORATION
- Practice address
- 217 N Main St
Edgerton, WI 53534-1613 - Phone
- (608) 884-9431
- NPI assigned
- Mar 9, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- MERCYROCKFORD HEALTH SYSTEM CORPORATION
Authorized official
- Name
- John W Cook
- Title
- Senior VP/Cfo
- Phone
- (608) 756-6000
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0709442 | Mercy Edgerton Medical Center | Certificate of waiver | Jan 29, 2028 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 310-800 | WI | Yes |
Addresses
Primary practice location
217 N Main St
Edgerton, WI 53534-1613
Mailing address
1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52D0709442 | Other | CLIA |
Other names
- MERCY EDGERTON MEDICAL CENTER
Other providers in Edgerton, WI
- Krystal Lucas
- Julie Louise Lyerla
- Sandra K Matzke
- Rachael McGauley
- Donna Lee Meister
- Aaron Peter Mertes
- Amy D. Millard
- Robert Newell Miller IV
- Nicholas Alan Mills
- Milton & Edgerton Vision Centers, LLC
All providers in Edgerton, WI · Durable Medical Equipment & Medical Supplies in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.