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General NPI Number Information
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NPI Number | 1407135130
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Entity Type | Organization
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Legal Business Name | HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC.
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Dates
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Enumeration Date | 08/11/2011
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Last Update Date | 11/06/2014
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Provider Practice Location Address
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Address Line | 101 E WASHINGTON ST
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City | PITTSFIELD
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State | IL
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Zip | 62363-1436
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Country | US
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Telephone | 217-285-5012
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Fax | 217-285-4519
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Provider Business Mailing Address
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Address Line | 6500 HOSPITAL DR P O BOX 1239
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City | HANNIBAL
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State | MO
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Zip | 63401-6890
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Country | US
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Telephone | 573-406-5888
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Fax | 573-406-5889
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Authorized Official
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Title or Position | CFO
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Name | DIX ROGER
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Credential |
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Telephone | 573-248-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046009247
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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