Healthcare Provider Details
I. General information
NPI: 1821279837
Provider Name (Legal Business Name): HUTCHISON MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/19/2007
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16561 N COUNTY FARM LN
MOUNT VERNON IL
62864-7934
US
IV. Provider business mailing address
16561 N COUNTY FARM LN
MOUNT VERNON IL
62864-7934
US
V. Phone/Fax
- Phone: 618-237-6000
- Fax: 800-750-8650
- Phone: 618-237-6000
- Fax: 800-750-8650
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BN1400X |
| Taxonomy | Nursing Facility Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ALAN
DALE
HUTCHISON
Title or Position: PRESIDENT
Credential:
Phone: 618-237-6000