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General NPI Number Information
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NPI Number | 1053378349
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Entity Type | Organization
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Legal Business Name | THE CARLE FOUNDATION HOSPITAL
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 200 LERNA RD S STE 101
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City | MATTOON
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State | IL
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Zip | 61938-9301
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Country | US
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Telephone | 217-258-7600
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Fax | 217-258-3878
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Provider Business Mailing Address
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Address Line | 611 W PARK
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City | URBANA
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State | IL
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Zip | 61801
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Country | US
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Telephone | 217-383-3311
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Fax | 217-235-6460
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Authorized Official
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Title or Position | CEO
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Name | JAMES LEONARD
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Credential | MD
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Telephone | 217-383-3220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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