Healthcare Provider Details

I. General information

NPI: 1801970017
Provider Name (Legal Business Name): SARAH BUSH LINCOLN HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HEALTH CENTER DR
MATTOON IL
61938
US

IV. Provider business mailing address

1000 HEALTH CENTER DR
MATTOON IL
61938-4644
US

V. Phone/Fax

Practice location:
  • Phone: 217-258-2411
  • Fax: 217-258-4095
Mailing address:
  • Phone: 217-258-2411
  • Fax: 217-258-4095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number054008478
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number054008478
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number054008478
License Number StateIL

VIII. Authorized Official

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