Healthcare Provider Details

I. General information

NPI: 1821952524
Provider Name (Legal Business Name): SARAH BUSH LINCOLN HOME INFUSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HEALTH CENTER DR STE G110
MATTOON IL
61938-4644
US

IV. Provider business mailing address

1000 HEALTH CENTER DR STE G110
MATTOON IL
61938-4644
US

V. Phone/Fax

Practice location:
  • Phone: 217-258-2164
  • Fax: 217-258-2280
Mailing address:
  • Phone: 217-258-2164
  • Fax: 217-258-2280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW CLIFTON
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 217-258-2518