Healthcare Provider Details
I. General information
NPI: 1932242518
Provider Name (Legal Business Name): BLESSING HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/14/2007
Last Update Date: 01/11/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5011 OAK STREET
QUINCY IL
62301
US
IV. Provider business mailing address
1005 BROADWAY ST
QUINCY IL
62301-2834
US
V. Phone/Fax
- Phone: 217-223-8400
- Fax: 217-223-9945
- Phone: 217-223-8400
- Fax: 217-223-9945
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 315D00000X |
| Taxonomy | Inpatient Hospice |
| License Number | 0000141 |
| License Number State | IL |
VIII. Authorized Official
Name: MR.
TIMOTHY
A
MOORE
Title or Position: VP, FINANCE, CAO
Credential:
Phone: 217-223-8400