| Mercyone Clive Ent Care Clinic | |
|
1601 Nw 114th St Suite 230 Clive IA 50325-7007 | |
| (515) 222-7761 | |
| (515) 222-7926 |
| Full Name | Mercyone Clive Ent Care Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 1601 Nw 114th St, Clive, Iowa |
| Authorized Official Name and Position | Bradley Whipple (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 5153586956 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercyone Clive Ent Care Clinic Po Box 1475 Des Moines IA 50305-1475 Ph: (515) 222-7761 | Mercyone Clive Ent Care Clinic 1601 Nw 114th St Suite 230 Clive IA 50325-7007 Ph: (515) 222-7761 |
| NPI Number | 1912187311 |
|---|---|
| Provider Enumeration Date | 11/14/2007 |
| Last Update Date | 10/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912187311 | NPI | - | NPPES |
| 0210005 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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