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General NPI Number Information
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NPI Number | 1740534163
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Entity Type | Organization
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Legal Business Name | HOOPESTON RETIREMENT VILLAGE FOUNDATION, INC
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Dates
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Enumeration Date | 11/07/2012
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Last Update Date | 11/07/2012
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Provider Practice Location Address
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Address Line | 423 N DIXIE HWY
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City | HOOPESTON
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State | IL
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Zip | 60942-1033
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Country | US
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Telephone | 217-283-8247
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Fax | 217-283-6406
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Provider Business Mailing Address
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Address Line | 115 W JEFFERSON ST SUITE 401
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City | BLOOMINGTON
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State | IL
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Zip | 61701-3946
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Country | US
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Telephone | 309-828-4361
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Fax | 309-829-5477
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Authorized Official
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Title or Position | EXEC VP, CFO
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Name | CRAIG L ATER
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Credential |
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Telephone | 309-823-7135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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