MEDICARE: TOUCHETTE REGIONAL HOSPITAL - TRANSPORTATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1053853143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOUCHETTE REGIONAL HOSPITAL - TRANSPORTATION

Provider Business Mailing Address
First Line	:	5900 BOND AVE
Second Line	:
City	:	CAHOKIA HEIGHTS
State	:	IL
Zip	:	62207-2326
Country	:	US
Telephone Number	:	618-332-3060
Fax Number	:	618-332-5256

Provider Business Practice Location Address
First Line	:	5900 BOND AVE
Second Line	:
City	:	CAHOKIA HEIGHTS
State	:	IL
Zip	:	62207-2326
Country	:	US
Telephone Number	:	618-332-3060
Fax Number	:	618-332-5430

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BRAD GOACHER
Credential	:
Telephone Number	:	618-332-3060

Provider Enumeration Date	:	11/07/2016
Last Update Date	:	10/14/2025

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