Organization Name: | RURAL CHAMPAIGN CO SPC ED COOP |
NPI Number: | 1598897993 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SCOTT HOGAN (EXECUTIVE DIRECTOR) |
Mailing Address: | 201 S Sheldon St Rantoul |
State: | IL US |
Postal Code: | 618662400 |
Phone Number: | 2178928877 |
Fax Number: | |
NPI Enumeration Date: | 03/12/2007 |
NPI Last Update Date: | 09/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Student Health |
Taxonomy Definition: |