Healthcare Provider Details

I. General information

NPI: 1689378523
Provider Name (Legal Business Name): BLESSING HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 BROADWAY ST RM 1952-304
QUINCY IL
62301-2834
US

IV. Provider business mailing address

1005 BROADWAY ST RM 1952-304
QUINCY IL
62301-2834
US

V. Phone/Fax

Practice location:
  • Phone: 217-277-3525
  • Fax: 217-277-3526
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JULIE A DUKE
Title or Position: CHIEF REVENUE CYCLE OFFICER
Credential:
Phone: 217-223-8400