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General NPI Number Information
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NPI Number | 1306987201
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Entity Type | Organization
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Legal Business Name | HAMMOND HENRY HOSPITAL
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 600 N COLLEGE AVE
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City | GENESEO
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State | IL
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Zip | 61254-1091
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Country | US
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Telephone | 309-944-9139
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Fax | 309-944-9262
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Provider Business Mailing Address
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Address Line | 600 N COLLEGE AVE
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City | GENESEO
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State | IL
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Zip | 61254-1091
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Country | US
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Telephone | 309-944-9139
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Fax | 309-944-9262
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Authorized Official
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Title or Position | CEO
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Name | BRAD SOLBERG
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Credential |
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Telephone | 309-944-4625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 051034444
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License Number State | IL
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