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General NPI Number Information
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NPI Number | 1083897045
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Entity Type | Organization
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Legal Business Name | ADAMS COUNTY R S V P
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 1301 S 48TH ST
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City | QUINCY
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State | IL
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Zip | 62305-8736
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Country | US
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Telephone | 217-641-4960
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Fax | 217-641-4900
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Provider Business Mailing Address
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Address Line | 1301 S 48TH ST
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City | QUINCY
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State | IL
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Zip | 62305-8736
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Country | US
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Telephone | 217-641-4960
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Fax | 217-641-4900
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. CARLA J GOSNEY
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Credential |
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Telephone | 217-641-4960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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