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General NPI Number Information
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NPI Number | 1821184359
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Entity Type | Organization
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Legal Business Name | KEWANEE HOSPITAL
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1051 W SOUTH ST
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City | KEWANEE
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State | IL
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Zip | 61443-8354
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Country | US
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Telephone | 309-852-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 1051 W SOUTH ST
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City | KEWANEE
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State | IL
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Zip | 61443-8354
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Country | US
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Telephone | 309-852-7500
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Fax |
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Authorized Official
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Title or Position | BUSINESS OFC MANAGER
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Name | MR. JOE BERRY
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Credential |
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Telephone | 309-852-7540
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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 |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 002
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License Number State | IL
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