St. Mary'S Hospital
Clinic/Center, Rural Health in Vandalia, IL. Organization (NPI-2).
NPI number1790789451
StatusActive
Last updated in NPPESApr 20, 2008
Details
- NPI
- 1790789451
- Entity type
- Organization (NPI-2)
- Legal business name
- St. Mary'S Hospital
- Organization subpart
- Yes
- Enumeration date
- Jun 10, 2005
- Last updated
- Apr 20, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR1300X | Clinic/Center, Rural Health | 0002642 | IL | Yes |
Practice location
825 New York DrSte 2
Vandalia, IL 62471-1044
Phone 618-283-0600
Mailing address
Po Box 503861Saint Louis, MO 63150-0001
Phone 618-436-8000
Authorized official
Bruce Merrell
President
6184366205
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