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General NPI Number Information
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NPI Number | 1205105087
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Entity Type | Organization
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Legal Business Name | SSM HEALTH BUSINESSES
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Dates
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Enumeration Date | 12/22/2011
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 20 JUNCTION DR W UNIT 4
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City | GLEN CARBON
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State | IL
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Zip | 62034-3060
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Country | US
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Telephone | 618-288-8020
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Fax | 618-288-8019
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Provider Business Mailing Address
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Address Line | 20 JUNCTION DR W STE 4
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City | GLEN CARBON
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State | IL
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Zip | 62034-3060
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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 | VICE PRESIDENT PATIENT CARE SERVICE
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Name | LISA SUE SCHWEITZER
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Credential | RN
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Telephone | 608-778-2146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1010902
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License Number State | IL
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