Organization Name: | HENDERSON COUNTY RURAL HEALTH CENTER, INC. |
NPI Number: | 1104017417 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MELINDA R WHITEMAN (EXECUTIVE DIRECTOR) |
Mailing Address: | 1400 E Carroll St Ste B Macomb |
State: | IL US |
Postal Code: | 614551801 |
Phone Number: | 3098332500 |
Fax Number: | 3098331760 |
NPI Enumeration Date: | 08/05/2007 |
NPI Last Update Date: | 09/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | 019027400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |