| Mercy West Pediatric Clinic | |
|
1601 Nw 114th St Ste 345 Clive IA 50325-7036 | |
| (515) 222-7337 | |
| (515) 222-7340 |
| Full Name | Mercy West Pediatric Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 1601 Nw 114th St Ste 345, Clive, Iowa |
| Authorized Official Name and Position | Sharon Phillips (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 5153586960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy West Pediatric Clinic Po Box 1475 Des Moines IA 50305-1475 Ph: (515) 222-7337 | Mercy West Pediatric Clinic 1601 Nw 114th St Ste 345 Clive IA 50325-7036 Ph: (515) 222-7337 |
| NPI Number | 1669652061 |
|---|---|
| Provider Enumeration Date | 11/14/2007 |
| Last Update Date | 04/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669652061 | NPI | - | NPPES |
| 29003 | Other | IA | WELLMARK BLUE SHIELD |
| 1236174 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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