Healthcare Provider Details

I. General information

NPI: 1720982960
Provider Name (Legal Business Name): SARAH BUSH LINCOLN HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 N. MAPLE DR. SUITE 101
EFFINGHAM IL
62401
US

IV. Provider business mailing address

902 N. MAPLE DR. SUITE 101
EFFINGHAM IL
62401
US

V. Phone/Fax

Practice location:
  • Phone: 217-258-2411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: MATTHEW CLIFTON
Title or Position: DIRECTOR OF PHARMACY
Credential: PHARM D
Phone: 217-258-2518