Healthcare Provider Details

I. General information

NPI: 1831174994
Provider Name (Legal Business Name): AMERICAN HEALTH CORPORATION AND SUBSIDIARIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 04/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S MAIN ST
FARMINGTON IL
61531-1460
US

IV. Provider business mailing address

701 S MAIN ST
FARMINGTON IL
61531-1460
US

V. Phone/Fax

Practice location:
  • Phone: 309-245-2407
  • Fax:
Mailing address:
  • Phone: 309-245-2407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0045187
License Number StateIL

VIII. Authorized Official

Name: MRS. MARY ELIZABETH HUGHES
Title or Position: OFFICE MANAGER
Credential:
Phone: 309-245-2407