Healthcare Provider Details

I. General information

NPI: 1659321560
Provider Name (Legal Business Name): WASHINGTON COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 S GRAND ST
NASHVILLE IL
62263-1534
US

IV. Provider business mailing address

705 S GRAND ST
NASHVILLE IL
62263-1534
US

V. Phone/Fax

Practice location:
  • Phone: 618-327-2201
  • Fax: 618-327-2209
Mailing address:
  • Phone: 618-327-2201
  • Fax: 618-327-2209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number0002899
License Number StateIL

VIII. Authorized Official

Name: NANCY NEWBY
Title or Position: CEO
Credential:
Phone: 618-327-2201