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General NPI Number Information
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NPI Number | 1093783896
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Entity Type | Organization
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Legal Business Name | HARRISBURG MEDICAL CENTER INC
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 04/04/2018
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Provider Practice Location Address
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Address Line | 100 DR WARREN TUTTLE DR
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City | HARRISBURG
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State | IL
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Zip | 62946-2718
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Country | US
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Telephone | 618-253-7671
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Fax | 618-252-3763
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Provider Business Mailing Address
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Address Line | 100 DR WARREN TUTTLE DR
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City | HARRISBURG
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State | IL
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Zip | 62946-2718
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Country | US
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Telephone | 618-253-7671
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Fax | 618-252-3763
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. DONALD HUTSON
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Credential |
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Telephone | 618-253-7671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | 0000521
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License Number State | IL
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