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General NPI Number Information
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NPI Number | 1629056056
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Entity Type | Organization
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Legal Business Name | ANDERSON HOSPITAL
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Dates
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Enumeration Date | 01/05/2006
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 2133 VADALABENE DR
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City | MARYVILLE
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State | IL
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Zip | 62062-5839
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Country | US
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Telephone | 618-288-9355
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Fax | 618-288-6978
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Provider Business Mailing Address
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Address Line | 2133 VADALABENE DR
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City | MARYVILLE
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State | IL
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Zip | 62062-5839
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Country | US
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Telephone | 618-288-9355
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Fax | 618-288-6978
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Authorized Official
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Title or Position | CFO
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Name | PATRICK J GARVEY
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Credential |
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Telephone | 618-391-6421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1004019
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License Number State | IL
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