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NPI Code Detail

MEDICARE: BROMENN HEALTHCARE INC

MEDICARE: BROMENN HEALTHCARE 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 Hospital1748518IL

General Provider Information

NPI Number : 1144241605
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROMENN HEALTHCARE INC
Provider Business Mailing Address
First Line : PO BOX 2850
Second Line :
City : BLOOMINGTON
State : IL
Zip : 61702-2850
Country : US
Telephone Number : 309-454-1400
Fax Number :
Provider Business Practice Location Address
First Line : 1304 FRANKLIN AVE
Second Line :
City : NORMAL
State : IL
Zip : 61761-3558
Country : US
Telephone Number : 309-454-1400
Fax Number :
Authorized Official
Title or Position : VP/CFO
Name : MRS. PENNY CERMAK
Credential :
Telephone Number : 309-268-2185
Provider Enumeration Date : 07/21/2006
Last Update Date : 01/19/2010

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