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General NPI Number Information
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NPI Number | 1881779494
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Entity Type | Organization
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Legal Business Name | BOND COUNTY TREASURER
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 01/12/2015
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Provider Practice Location Address
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Address Line | 1520 S 4TH ST
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City | GREENVILLE
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State | IL
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Zip | 62246-2618
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Country | US
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Telephone | 618-664-5020
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Fax | 618-664-9682
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Provider Business Mailing Address
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Address Line | 1520 S 4TH ST
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City | GREENVILLE
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State | IL
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Zip | 62246-2618
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Country | US
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Telephone | 618-664-5020
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Fax | 618-664-9682
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | TARA WALTER
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Credential |
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Telephone | 618-664-5020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State | IL
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