Healthcare Provider Details

I. General information

NPI: 1760667885
Provider Name (Legal Business Name): UNION HOSPITAL INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 04/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 N 2ND ST
MARSHALL IL
62441-1010
US

IV. Provider business mailing address

PO BOX 2505
INDIANAPOLIS IN
46206-2505
US

V. Phone/Fax

Practice location:
  • Phone: 217-826-2361
  • Fax: 217-826-8120
Mailing address:
  • Phone: 812-238-7783
  • Fax: 812-238-4506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHY PALLUTCH
Title or Position: DIRECTOR
Credential:
Phone: 812-238-7783