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General NPI Number Information
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NPI Number | 1427366012
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Entity Type | Organization
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Legal Business Name | COUNTY OF COLES
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Dates
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Enumeration Date | 09/17/2010
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 825 18TH ST
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City | CHARLESTON
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State | IL
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Zip | 61920-2940
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Country | US
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Telephone | 217-348-0530
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Fax |
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Provider Business Mailing Address
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Address Line | 825 18TH ST
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City | CHARLESTON
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State | IL
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Zip | 61920-2936
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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 | DIRECTOR OF NURSING
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Name | MRS. CATHIE REYNOLDS
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Credential |
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Telephone | 217-348-0530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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