NPIMap

Organization Active NPI

Mercy Health Services-Iowa Corp

  • Long Term Care Pharmacy
  • Mason City, IA
National Provider Identifier
1801975065
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
1140 Issued in IA
Legal business name
MERCY HEALTH SERVICES-IOWA CORP
Practice address
910 N Eisenhower Ave
Mason City, IA 50401-1525
Phone
(641) 428-6944
Fax
(641) 428-6946
NPI assigned
Nov 6, 2006
Last updated
Oct 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Authorized official

Name
Mark Trammel
Title
Asst Treasurer
Phone
(641) 428-7984

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Long Term Care Pharmacy 3336L0003X 1140 IA Primary

Addresses

Primary practice location

910 N Eisenhower Ave
Mason City, IA 50401-1525

Mailing address

PO Box 1159
Mason City, IA 50402-1159
Phone (641) 428-6944

Other identifiers 3

IdentifierTypeStateIssuer
2030059OtherPK
00223750MedicaidIA
143410100MedicaidMN

Other names 1

  • MercyOne Mason City Long Term Care Pharmacy Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930027428 IA DME Supplier - Pharmacy 7618884438 Practice locations: Mason City, IA
O20170606001785 IA Part B Supplier - Mass Immunization (Roster Biller Only) 7618884438 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sheffield, IA; Northwood, IA; Mason City, IA; Greene, IA; Clear Lake, IA

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Forest Park Pediatrics16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 14

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercyone Dyersville Medical CenterDyersville, IA, CCN 16Z378 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 19, 1998
Mercyone Dyersville Medical CenterDyersville, IA, CCN 161378 Hospital 5% Or Greater Indirect Ownership Interest (100%) Aug 19, 1998
Mercyone New Hampton Medical CenterNew Hampton, IA, CCN 161331 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 19, 1998
Mercyone New Hampton Medical Center Swing BedNew Hampton, IA, CCN 16Z331 Hospital 5% Or Greater Direct Ownership Interest (100%) Mar 23, 2018
Mercyone Dubuque Medical CenterDubuque, IA, CCN 160069 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966
Mercyone Clinton Medical CenterClinton, IA, CCN 160080 Hospital 5% Or Greater Indirect Ownership Interest (100%) Aug 19, 1998
Mercyone Dubuque Medical CenterDubuque, IA, CCN 16T069 Hospital 5% Or Greater Direct Ownership Interest (100%) Mar 2, 2015
Bethany HomeDubuque, IA, CCN 165584 Skilled nursing facility Adp of the SNF Dec 1, 1995
Rockwell Community Nursing HomeRockwell, IA, CCN 165406 Skilled nursing facility Adp of the SNF Dec 1, 2018
Mercyone North Iowa HospiceMason City, IA, CCN 161503 Hospice 5% Or Greater Direct Ownership Interest (100%) Jan 10, 2012
Mercyone Correctionville Family MedicineCorrectionville, IA, CCN 168934 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 19, 1998
Mercyone Kingsley Family MedicineKingsley, IA, CCN 163846 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 19, 1998
Mercyone Anthon Family MedicineAnthon, IA, CCN 168945 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 19, 1998
Mercyone Primghar Family MedicinePrimghar, IA, CCN 168987 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 19, 1998

Owned or controlled facilities with NPI records 14

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1801975065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1159",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504021159",
            "telephone_number": "641-428-6944",
            "fax_number": "641-428-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 N EISENHOWER AVE",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504011525",
            "telephone_number": "641-428-6944",
            "fax_number": "641-428-6946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH SERVICES-IOWA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "TRAMMEL",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "ASST TREASURER",
        "authorized_official_telephone_number": "641-428-7984"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IA",
            "license": "1140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2030059",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00223750",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143410100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MercyOne Mason City Long Term Care Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mason City, IA

Sources for this page

Verify at the official NPI Registry.