MASSAC MEMORIAL HOSPITAL NPI 1740355809

NPI Information

NPI: 1740355809
Provider Name: MASSAC MEMORIAL HOSPITAL

Doing Business As: MASSAC MEMORIAL MEDICAL CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
1204 W 10TH ST
METROPOLIS, IL
ZIP 62960
Phone: (618) 524-2176
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MASSAC MEMORIAL HOSPITAL is a rural health clinic center in Metropolis, IL. MASSAC MEMORIAL HOSPITAL NPI is 1740355809. The provider is registered as an organization entity type.
The provider Is Doing Business As Massac Memorial Medical Clinic.

The provider's business location address is:

1204 W 10TH ST
METROPOLIS, IL
ZIP 62960-790
Phone: (618) 524-2176
Fax: (618) 524-4131

The provider's authorized official is Lynn Goines .
The authorized official title is Cfo and has the following contact phone number (618) 524-2176.

The CLIA number assigned to this NPI record is 14D0045094 - hospital with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 11/22/2006 and was last updated on 10/24/2018.

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
1	261QR1300X	Clinic/Center	Rural Health	0001420	ILLINOIS	Yes

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

NPI Synchronization or Removal

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