Healthcare Provider Details

I. General information

NPI: 1386024016
Provider Name (Legal Business Name): RICHLAND MEMORIAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2015
Last Update Date: 06/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S SCOTT AVE
NEWTON IL
62448-1665
US

IV. Provider business mailing address

800 E LOCUST ST
OLNEY IL
62450-2553
US

V. Phone/Fax

Practice location:
  • Phone: 618-783-2144
  • Fax: 618-783-2541
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateIL

VIII. Authorized Official

Name: DAVID ALLEN
Title or Position: CEO
Credential:
Phone: 618-395-7340