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SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP NPI 1245260645


NPI Information

NPI: 1245260645
Provider Name: SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP

Doing Business As: SHAWNEE HEALTH CARE, MURPHYSBORO

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
7 SOUTH HOSPITAL DRIVE
MURPHYSBORO, IL
ZIP 62966
Phone: (618) 687-3418
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SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP is a federally qualified health center (fqhc) clinic center in Murphysboro, IL. SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP NPI is 1245260645. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Shawnee Health Care, Murphysboro.

The provider's business location address is:

7 SOUTH HOSPITAL DRIVE
MURPHYSBORO, IL
ZIP 62966-333
Phone: (618) 687-3418
Fax: (618) 684-2748

The provider's authorized official is Christina Carney .
The authorized official title is Ceo and has the following contact phone number (618) 956-9521.

The enumeration date for this NPI number is 7/3/2006 and was last updated on 4/4/2024.


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
2261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

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
110032052OTHERILLINOISBCBS

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.