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General NPI Number Information
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NPI Number | 1710943907
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Entity Type | Organization
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Legal Business Name | HAMILTON MEMORIAL HOSPITAL DISTRICT
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 112 S WASHINGTON ST
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City | MC LEANSBORO
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State | IL
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Zip | 62859-1147
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Country | US
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Telephone | 618-643-4415
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Fax | 618-643-4508
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Provider Business Mailing Address
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Address Line | 611 S MARSHALL AVE PO BOX 429
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City | MC LEANSBORO
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State | IL
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Zip | 62859-1213
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Country | US
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Telephone | 618-643-4415
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Fax | 618-643-4508
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Authorized Official
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Title or Position | CFO
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Name | MR. JUSTIN EPPERSON
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Credential |
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Telephone | 618-643-2361
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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 | 1001486
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License Number State | IL
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