Organization Name: | SOUTHERN ILLINOIS UNIVERSITY EDWARDSVILLE |
NPI Number: | 1518140326 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NANCY UFERT (DIRECTOR OF PURCHASING) |
Mailing Address: | 601 James R Thompson Blvd Building D 2015 East Saint Louis |
State: | IL US |
Postal Code: | 622011129 |
Phone Number: | 6184826959 |
Fax Number: | 6184828311 |
NPI Enumeration Date: | 12/14/2007 |
NPI Last Update Date: | 07/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |