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NPI Code Detail

MEDICARE: HARRISBURG MEDICAL CENTER INC

MEDICARE: HARRISBURG MEDICAL CENTER INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282N00000XGeneral Acute Care Hospital0000521IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1143471OTHERILHEALTHLINK PROVIDER NUMBE
23575OTHERILHEALTH ALLIANCE
3364OTHERILBLUE CROSS PROVIDER NUMBE

General Provider Information

NPI Number : 1073580130
Entity Type Code : Organization
Provider Name (Legal Business Name) : HARRISBURG MEDICAL CENTER INC
Provider Business Mailing Address
First Line : 100 DR WARREN TUTTLE DR
Second Line :
City : HARRISBURG
State : IL
Zip : 62946-2718
Country : US
Telephone Number : 618-253-7671
Fax Number : 618-252-3763
Provider Business Practice Location Address
First Line : 100 DR WARREN TUTTLE DR
Second Line :
City : HARRISBURG
State : IL
Zip : 62946-2718
Country : US
Telephone Number : 618-253-7671
Fax Number : 618-252-3763
Authorized Official
Title or Position : CEO/PRESIDENT
Name : DONALD HUTSON
Credential :
Telephone Number : 618-253-7671
Provider Enumeration Date : 03/07/2006
Last Update Date : 04/04/2018

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