Healthcare Provider Details

I. General information

NPI: 1013011618
Provider Name (Legal Business Name): WABASH GENERAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1418 COLLEGE DR
MOUNT CARMEL IL
62863-2638
US

IV. Provider business mailing address

1418 COLLEGE DR
MOUNT CARMEL IL
62863-2638
US

V. Phone/Fax

Practice location:
  • Phone: 618-262-8621
  • Fax:
Mailing address:
  • Phone: 618-262-8621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number0002865
License Number StateIL

VIII. Authorized Official

Name: MS. KARISSA TURNER
Title or Position: CEO
Credential:
Phone: 618-262-8621