NPIMap

Organization Active NPI

Mercy Family Pharmacy

Doing business as Mercy Family Pharmacy West

  • Community/Retail Pharmacy
  • Dubuque, IA
National Provider Identifier
1962573774
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
879 Issued in IA
Legal business name
MERCY FAMILY PHARMACY
Doing business as
Mercy Family Pharmacy West
Practice address
1500 Associates Dr
Dubuque, IA 52002-2201
Phone
(563) 584-4405
Fax
(563) 584-4404
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Authorized official

Name
Kay Takes
Title
President
Phone
(563) 589-8061

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 879 IA Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

1500 Associates Dr
Dubuque, IA 52002-2201

Mailing address

1500 Associates Dr
Dubuque, IA 52002-2260
Phone (563) 584-4405

Other identifiers 2

IdentifierTypeStateIssuer
0480442MedicaidIA
2029510OtherPK

Other names 1

  • MERCY FAMILY PHARMACY WEST Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190227000493 IA Part B Supplier - Pharmacy 4688667025 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cascade, IA; Dyersville, IA; Dubuque, IA

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Member of 1

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

Locations

250 Mercy Dr
Dubuque, IA 52001
Phone (563) 589-8000

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574640000000",
    "number": "1962573774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022260",
            "telephone_number": "563-584-4405",
            "fax_number": "563-584-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022201",
            "telephone_number": "563-584-4405",
            "fax_number": "563-584-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY FAMILY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2019-11-25",
        "status": "A",
        "authorized_official_last_name": "TAKES",
        "authorized_official_first_name": "KAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-589-8061"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "879",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0480442",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2029510",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MERCY FAMILY PHARMACY WEST",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MERCY FAMILY PHARMACY WEST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.