NPIMap

Organization Active NPI

Mercy Medical Center

Doing business as Hall Perrine Cancer Center Pharmacy

  • Community/Retail Pharmacy
  • Cedar Rapids, IA
National Provider Identifier
1184974677
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1406 Issued in IA
Legal business name
MERCY MEDICAL CENTER
Doing business as
Hall Perrine Cancer Center Pharmacy
Mercy Home Medical Equipment
Mercy Renew Image Center
Practice address
701 10TH Street SE
Cedar Rapids, IA 52403-1292
Phone
(319) 363-1308
Fax
(319) 369-4718
NPI assigned
Sep 12, 2012
Last updated
Mar 3, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY MEDICAL CENTER, CEDAR RAPIDSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Timothy L Charles
Title
President and Ceo
Phone
(319) 398-6697

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 570036H IA
Community/Retail Pharmacy 3336C0003X 1406 IA Primary

Addresses

Primary practice location

701 10TH Street SE
Cedar Rapids, IA 52403-1292

Mailing address

701 10TH Street SE
Cedar Rapids, IA 52403-1292
Phone (319) 398-6011

Other identifiers 1

IdentifierTypeStateIssuer
0295857MedicaidIA

Other names 3

  • Hall Perrine Cancer Center Pharmacy Doing business as
  • Mercy Home Medical Equipment Doing business as
  • Mercy Renew Image Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mercy Medical Center10 organizations share this tax ID, including this one
Part of
Mercy Medical Center

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1184974677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 10TH STREET SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524031292",
            "telephone_number": "319-398-6011",
            "fax_number": "319-398-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 10TH STREET SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524031292",
            "telephone_number": "319-363-1308",
            "fax_number": "319-369-4718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY MEDICAL CENTER, CEDAR RAPIDS",
        "enumeration_date": "2012-09-12",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "319-398-6697"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IA",
            "license": "570036H",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "1406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0295857",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hall Perrine Cancer Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy Home Medical Equipment",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy Renew Image Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.