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General NPI Number Information
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NPI Number | 1285126631
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Entity Type | Organization
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Legal Business Name | ST MARYS HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS
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Dates
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Enumeration Date | 06/01/2018
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Last Update Date | 09/19/2023
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Provider Practice Location Address
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Address Line | 1800 E LAKE SHORE DR
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City | DECATUR
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State | IL
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Zip | 62521-3883
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Country | US
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Telephone | 217-464-2590
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Fax |
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Provider Business Mailing Address
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Address Line | 3051 HOLLIS DR
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City | SPRINGFIELD
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State | IL
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Zip | 62704-7450
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Country | US
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Telephone | 217-464-2590
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Fax |
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Authorized Official
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Title or Position | VP OF REVENUE CYCLE
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Name | MARK D EVARD
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Credential |
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Telephone | 217-492-9651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State | IL
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