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1790873297 NPI number — ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER

NPI Number: 1790873297
Health Care Provider/Practitioner: ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER

Information about “1790873297” NPI (ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER) exists in 1790873297 in HTML format HTML  |  1790873297 in plain Text format TXT  |  1790873297 in PDF (Portable Document Format) PDF  |  1790873297 in an XML format XML  formats.

NPI Number : 1790873297 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790873297",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3051 HOLLIS DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SPRINGFIELD",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "62704-7450",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "217-464-2966",
    "MailingAddressFaxNumber": "217-464-1609",
    "FirstLinePracticeLocationAddress": "1800 E LAKE SHORE DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DECATUR",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "62521-3810",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "217-464-2966",
    "PracticeLocationAddressFaxNumber": "217-464-1609",
    "EnumerationDate": "10/10/2006",
    "LastUpdateDate": "10/31/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "EVARD",
    "AuthorizedOfficialFirstName": "MARK",
    "AuthorizedOfficialMiddleName": "D",
    "AuthorizedOfficialTitle": "VP OF REVENUE CYCLE",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "217-492-9651",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "275N00000X",
        "TaxonomyName": "Medicare Defined Swing Bed Hospital Unit",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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