| Organization Name: | EDWARDSVILLE HEALTH CARE CENTER INVESTORS LLC |
| NPI Number: | 1023465507 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMMIE ADKINS (REGIONAL DIRECTOR OF A/R) |
| Mailing Address: | 1095 University Dr Edwardsville |
| State: | IL US |
| Postal Code: | 620253961 |
| Phone Number: | 6186561081 |
| Fax Number: | 6186567083 |
| NPI Enumeration Date: | 05/16/2016 |
| NPI Last Update Date: | 05/16/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |