Healthcare Provider Details

I. General information

NPI: 1205127529
Provider Name (Legal Business Name): HAMMOND HENRY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2011
Last Update Date: 04/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1604 CLEVELAND RD
COLONA IL
61241-8970
US

IV. Provider business mailing address

600 N COLLEGE AVE
GENESEO IL
61254-1091
US

V. Phone/Fax

Practice location:
  • Phone: 309-949-2999
  • Fax: 563-345-6786
Mailing address:
  • Phone: 309-944-6431
  • Fax: 563-456-6788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number0000893
License Number StateIL

VIII. Authorized Official

Name: MR. BRADLEY SOLBERG
Title or Position: CEO
Credential:
Phone: 309-944-6431