MEDICARE: WABASH GENERAL HOSPITAL DISTRICT

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
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1942774153
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WABASH GENERAL HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	1418 COLLEGE DR
Second Line	:
City	:	MOUNT CARMEL
State	:	IL
Zip	:	62863-2638
Country	:	US
Telephone Number	:	618-262-8621
Fax Number	:	618-263-6467

Provider Business Practice Location Address
First Line	:	610 N COURT ST
Second Line	:
City	:	GRAYVILLE
State	:	IL
Zip	:	62844-1002
Country	:	US
Telephone Number	:	618-375-7101
Fax Number	:	618-375-7183

Authorized Official
Title or Position	:	CEO
Name	:	KARISSA LYNN TURNER
Credential	:
Telephone Number	:	618-263-6300

Provider Enumeration Date	:	01/22/2019
Last Update Date	:	04/03/2025

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