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CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION NPI 1053593533


NPI Information

NPI: 1053593533
Provider Name: CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION

Doing Business As: JOHNSTON CITY COMMUNITY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
14410 ROUTE 37
JOHNSTON CITY COMMUNITY HEALTH CENTER
JOHNSTON CITY, IL
ZIP 62951
Phone: (618) 983-6911
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CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION is a federally qualified health center (fqhc) clinic center in Johnston City, IL. CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION NPI is 1053593533. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Johnston City Community Health Center.

The provider's business location address is:

14410 ROUTE 37
JOHNSTON CITY COMMUNITY HEALTH CENTER
JOHNSTON CITY, IL
ZIP 62951
Phone: (618) 983-6911
Fax: (618) 724-2571

The provider's authorized official is Kim A. Mitroka .
The authorized official title is President/ C.e.o. and has the following contact phone number (618) 724-2401.

The enumeration date for this NPI number is 11/27/2007 and was last updated on 1/25/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2207R00000XInternal MedicineNo
3261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes
4363A00000XPhysician AssistantNo
5363LF0000XNurse PractitionerFamilyNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1036049529OTHERILLINOISCOMMUNITY HEALTH CENTER
2036049529MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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