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General NPI Number Information
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NPI Number | 1568500510
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Entity Type | Organization
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Legal Business Name | SARAH BUSH LINCOLN HEALTH CENTER
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 660 W TAYLOR ST STE 101
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City | VANDALIA
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State | IL
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Zip | 62471
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Country | US
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Telephone | 618-283-1231
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Fax |
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Provider Business Mailing Address
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Address Line | 650 W TAYLOR ST
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City | VANDALIA
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State | IL
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Zip | 62471-1227
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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 | CFO
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Name | SEAN FISCHER
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Credential |
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Telephone | 217-258-2591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 042007886
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License Number State | IL
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