Healthcare Provider Details

I. General information

NPI: 1871600858
Provider Name (Legal Business Name): FERRELL HOSPITAL COMMUNITY FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 PINE ST
ELDORADO IL
62930-1634
US

IV. Provider business mailing address

1201 PINE ST
ELDORADO IL
62930-1634
US

V. Phone/Fax

Practice location:
  • Phone: 618-273-3361
  • Fax: 618-273-5501
Mailing address:
  • Phone: 618-273-3361
  • Fax: 618-273-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number0005363
License Number StateIL

VIII. Authorized Official

Name: SHIRLEY ANGLETON
Title or Position: PFS DIRECTOR
Credential:
Phone: 618-273-3361