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NPI Code Detail

MEDICARE: GIBSON COMMUNITY HOSPITAL ASSOCIATION

MEDICARE: GIBSON COMMUNITY HOSPITAL ASSOCIATION
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
1261QR1300XRural Health Clinic/Center006IL
2261QR1300XRural Health Clinic/Center

General Provider Information

NPI Number : 1992700595
Entity Type Code : Organization
Provider Name (Legal Business Name) : GIBSON COMMUNITY HOSPITAL ASSOCIATION
Provider Business Mailing Address
First Line : 227 N MARKET ST
Second Line :
City : PAXTON
State : IL
Zip : 60957-1123
Country : US
Telephone Number : 217-379-4864
Fax Number : 217-379-6494
Provider Business Practice Location Address
First Line : 227 N MARKET ST
Second Line :
City : PAXTON
State : IL
Zip : 60957-1123
Country : US
Telephone Number : 217-379-4864
Fax Number : 217-379-6494
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : MATTHEW ERTEL
Credential :
Telephone Number : 217-784-2601
Provider Enumeration Date : 06/20/2005
Last Update Date : 07/21/2022

Similar Medicare Providers

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1477800175 — MRS. KELLI MARIE VAUGHN FNP-BC
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1831742204 — KELLY DAWN COOKE PT, DPT
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Directions to “GIBSON COMMUNITY HOSPITAL ASSOCIATION ” Practice Location

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