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General NPI Number Information
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NPI Number | 1275730483
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Entity Type | Organization
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Legal Business Name | VAIHCS
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 07/28/2008
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Provider Practice Location Address
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Address Line | VAIHCS 1900 EAST MAIN
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City | DANVILLE
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State | IL
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Zip | 61832
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Country | US
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Telephone | 217-554-5519
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Fax |
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Provider Business Mailing Address
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Address Line | 15361 COLLEGE AVE
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City | GEORGETOWN
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State | IL
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Zip | 61846-6135
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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 | RN
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Name | TAMARA J WEISS
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Credential |
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Telephone | 217-554-5519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 41353765
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License Number State | IL
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