Healthcare Provider Details

I. General information

NPI: 1194720821
Provider Name (Legal Business Name): INDEPENDENCE HOLDING CO., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 KEOKUK ST
LINCOLN IL
62656-1731
US

IV. Provider business mailing address

3063 FIAT AVE
SPRINGFIELD IL
62703-5930
US

V. Phone/Fax

Practice location:
  • Phone: 217-735-3415
  • Fax: 217-732-7319
Mailing address:
  • Phone: 866-232-1222
  • Fax: 217-467-8299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number054-14414
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number054-14414
License Number StateIL

VIII. Authorized Official

Name: MR. JAMES CHRISTOPHER SMITH
Title or Position: VICE PRESIDENT
Credential:
Phone: 866-232-1222