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General NPI Number Information
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NPI Number | 1053792689
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Entity Type | Organization
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Legal Business Name | RICHLAND MEMORIAL HOSPITAL, INC.
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Dates
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Enumeration Date | 06/09/2015
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 1200 N EAST ST
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City | OLNEY
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State | IL
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Zip | 62450-2432
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Country | US
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Telephone | 618-392-2940
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Fax |
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Provider Business Mailing Address
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Address Line | 800 E LOCUST ST
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City | OLNEY
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State | IL
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Zip | 62450-2553
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | HARRY BROCKUS
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Credential |
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Telephone | 618-395-7340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State | IL
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