Healthcare Provider Details

I. General information

NPI: 1679220149
Provider Name (Legal Business Name): HARDIN COUNTY GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2022
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 FERRELL RD
ROSICLARE IL
62982-1052
US

IV. Provider business mailing address

PO BOX 2467
ROSICLARE IL
62982-2467
US

V. Phone/Fax

Practice location:
  • Phone: 618-285-6634
  • Fax: 618-285-3564
Mailing address:
  • Phone: 618-285-6634
  • Fax: 618-285-3564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ROBY WILLIAMS
Title or Position: CEO
Credential:
Phone: 618-285-6634