| Mercyone Johnston Pediatrics Care Clinic | |
|
5615 Nw 86th St Johnston IA 50131-1738 | |
| (515) 643-6000 | |
| (515) 643-6001 |
| Full Name | Mercyone Johnston Pediatrics Care Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 5615 Nw 86th St, Johnston, 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 Johnston Pediatrics Care Clinic Po Box 1475 Des Moines IA 50305-1475 Ph: (515) 643-6000 | Mercyone Johnston Pediatrics Care Clinic 5615 Nw 86th St Johnston IA 50131-1738 Ph: (515) 643-6000 |
| NPI Number | 1194741694 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 10/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194741694 | NPI | - | NPPES |
| 0209023 | Medicaid | IA | |
| CD3776 | Other | IA | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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