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General NPI Number Information
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NPI Number | 1104909407
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Entity Type | Organization
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Legal Business Name | COUNTY OF RICHLAND
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 208 E MAIN ST
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City | OLNEY
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State | IL
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Zip | 62450-2114
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Country | US
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Telephone | 618-392-6241
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Fax | 618-393-4078
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Provider Business Mailing Address
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Address Line | 208 E MAIN ST
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City | OLNEY
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State | IL
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Zip | 62450-2114
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Country | US
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Telephone | 618-392-6241
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Fax | 618-393-4078
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | SIDNEY HARRISON
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Credential |
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Telephone | 618-392-6241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041-189529
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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