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General NPI Number Information
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NPI Number | 1770152779
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Entity Type | Organization
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Legal Business Name | HAMMOND HENRY DIST HOSPITAL
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 106 N EAST ST
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City | CAMBRIDGE
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State | IL
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Zip | 61238-1157
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Country | US
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Telephone | 309-937-3560
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Fax |
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Provider Business Mailing Address
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Address Line | 600 N COLLEGE AVE
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City | GENESEO
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State | IL
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Zip | 61254-1091
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Country | US
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Telephone | 309-944-9123
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Fax | 309-944-9272
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Authorized Official
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Title or Position | VP OF FISCAL SERVICES
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Name | JODIE L CRISWELL
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Credential |
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Telephone | 309-944-9103
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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 |
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License Number State |
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