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General NPI Number Information
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NPI Number | 1053425124
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Entity Type | Organization
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Legal Business Name | CARLINVILLE AREA HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 20733 NORTH BROAD STREET
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City | CARLINVILLE
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State | IL
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Zip | 62626
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Country | US
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Telephone | 217-854-3857
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Fax | 217-854-3744
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Provider Business Mailing Address
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Address Line | 20733 NORTH BROAD STREET
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City | CARLINVILLE
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State | IL
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Zip | 62626
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Country | US
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Telephone | 217-854-3857
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Fax | 217-854-3744
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Authorized Official
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Title or Position | CEO
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Name | MR. BRIAN BURNSIDE
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Credential |
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Telephone | 217-854-3141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 0000182
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License Number State | IL
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