Healthcare Provider Details

I. General information

NPI: 1174923767
Provider Name (Legal Business Name): HOOPESTON COMMUNITY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2014
Last Update Date: 09/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E ORANGE ST
HOOPESTON IL
60942-1801
US

IV. Provider business mailing address

611 W PARK ST
URBANA IL
61801-2500
US

V. Phone/Fax

Practice location:
  • Phone: 217-383-6792
  • Fax: 217-383-4752
Mailing address:
  • Phone: 217-383-3311
  • Fax: 217-367-2827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateIL

VIII. Authorized Official

Name: MR. HARRY BROCKUS
Title or Position: CEO
Credential:
Phone: 217-283-8540