Healthcare Provider Details

I. General information

NPI: 1184644023
Provider Name (Legal Business Name): CARLE EUREKA HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 08/13/2020
Certification Date: 08/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S MAJOR ST
EUREKA IL
61530-1246
US

IV. Provider business mailing address

101 S MAJOR ST
EUREKA IL
61530-1246
US

V. Phone/Fax

Practice location:
  • Phone: 309-467-2371
  • Fax:
Mailing address:
  • Phone: 309-467-2371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number1706465
License Number StateIL

VIII. Authorized Official

Name: ARON KLEIN
Title or Position: VICE PRESIDENT FINANCE
Credential:
Phone: 309-268-2410