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General NPI Number Information
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NPI Number | 1396024162
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Entity Type | Organization
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Legal Business Name | LAWRENCE COUNTY MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 08/11/2011
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Last Update Date | 12/08/2022
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Provider Practice Location Address
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Address Line | 2200 STATE ST
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City | LAWRENCEVILLE
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State | IL
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Zip | 62439-1899
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Country | US
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Telephone | 618-943-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 STATE ST
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City | LAWRENCEVILLE
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State | IL
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Zip | 62439-1899
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Country | US
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Telephone | 618-943-1000
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | GERALD H KLEIN
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Credential |
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Telephone | 618-943-7202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 0005769
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License Number State | IL
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