Healthcare Provider Details
I. General information
NPI: 1699011882
Provider Name (Legal Business Name): FRANKLIN HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/17/2012
Last Update Date: 12/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
107 W FRANKLIN ST
SESSER IL
62884-1456
US
IV. Provider business mailing address
201 BAILEY LN
BENTON IL
62812-1969
US
V. Phone/Fax
- Phone: 618-625-5061
- Fax: 618-625-6738
- Phone: 618-439-3161
- Fax: 618-435-2969
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QC0050X |
| Taxonomy | Critical Access Hospital Clinic/Center |
| License Number | 0005231 |
| License Number State | IL |
VIII. Authorized Official
Name: MR.
MICHAEL
J.
BUDNICK
Title or Position: CHIEF OPERATING OFFICER/CLINIC MGR
Credential:
Phone: 618-439-3161