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General NPI Number Information
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NPI Number | 1740324250
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Entity Type | Organization
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Legal Business Name | GHSC - GIBSON HEALTH SERVICES CONTRACTS, INC.
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1468 STATE ST SUITE 200
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City | EAST SAINT LOUIS
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State | IL
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Zip | 62205-2010
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Country | US
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Telephone | 618-274-6026
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Fax | 618-274-4314
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Provider Business Mailing Address
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Address Line | 1468 STATE ST P. O. BOX 6017
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City | EAST SAINT LOUIS
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State | IL
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Zip | 62205-2010
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Country | US
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Telephone | 618-274-9667
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Fax | 618-274-4314
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MS. PATRICIA A GIBSON
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Credential | RN, BSN,MPH
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Telephone | 618-274-6026
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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 | 1009869
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License Number State | IL
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