HARRISBURG MEDICAL CENTER INC NPI 1992773873

NPI Information

NPI: 1992773873
Provider Name: HARRISBURG MEDICAL CENTER INC

Doing Business As: ELDORADO PRIMARY CARE

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

Specialization: Rural Health

Address:
1007 US ROUTE 45
ELDORADO, IL
ZIP 62930
Phone: (618) 273-7723
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HARRISBURG MEDICAL CENTER INC is a rural health clinic center in Eldorado, IL. HARRISBURG MEDICAL CENTER INC NPI is 1992773873. The provider is registered as an organization entity type.
The provider Is Doing Business As Eldorado Primary Care.

The provider's business location address is:

1007 US ROUTE 45
ELDORADO, IL
ZIP 62930
Phone: (618) 273-7723
Fax: (618) 273-3384

The provider's authorized official is Rodney D Smith .
The authorized official title is President/ceo and has the following contact phone number (618) 253-7671.

The CLIA number assigned to this NPI record is 14D0981555 - rural health clinic with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 3/8/2006 and was last updated on 10/15/2012.

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	0000521	ILLINOIS	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
1	=========401	MEDICAID	ILLINOIS
2	817400	OTHER	ILLINOIS	WPS PROVIDER NUMBER
3	143471	OTHER	ILLINOIS	HEALTHLINK
4	8315011	OTHER	ILLINOIS	BLUE CROSS PROVIDER NUMBE

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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