Healthcare Provider Details

I. General information

NPI: 1538347448
Provider Name (Legal Business Name): ANNA HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2008
Last Update Date: 02/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 N MAIN ST
ANNA IL
62906-1668
US

IV. Provider business mailing address

517 N MAIN ST
ANNA IL
62906-1668
US

V. Phone/Fax

Practice location:
  • Phone: 618-833-4511
  • Fax:
Mailing address:
  • Phone: 618-833-4511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: LAURIE HOLTSFORD
Title or Position: DIRECTOR BUSINESS OFFICE SUPPORT
Credential:
Phone: 615-465-7488