Healthcare Provider Details

I. General information

NPI: 1356325633
Provider Name (Legal Business Name): CRAWFORD HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 04/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 NORTH ALLEN STREET
ROBINSON IL
62454-1168
US

IV. Provider business mailing address

1000 N ALLEN ST
ROBINSON IL
62454-1167
US

V. Phone/Fax

Practice location:
  • Phone: 618-544-3699
  • Fax: 618-546-7636
Mailing address:
  • Phone: 618-544-3131
  • Fax: 618-546-2641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. DEBBIE A KIEHL
Title or Position: PRACTICE MANAGEMENT OFFICER
Credential:
Phone: 618-544-8600