Healthcare Provider Details

I. General information

NPI: 1528014834
Provider Name (Legal Business Name): RICHLAND MEMORIAL HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 05/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E LOCUST ST
OLNEY IL
62450-2553
US

IV. Provider business mailing address

800 E LOCUST ST
OLNEY IL
62450-2553
US

V. Phone/Fax

Practice location:
  • Phone: 618-395-7340
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: HARRY BROCKUS
Title or Position: CEO
Credential:
Phone: 217-283-8540