Shawnee Health Service And Development Corp in Carterville - Federally Qualified Health Center (fqhc)
Shawnee Health Service And Development Corp - NPI 1326079245
Shawnee Health Service And Development Corp is a Federally Qualified Health Center (fqhc) in Carterville, Illinois. Shawnee Health Service And Development Corp practices all healthcare services and medical treatments related to Federally Qualified Health Center (fqhc). The NPI Number for Shawnee Health Service And Development Corp is 1326079245. The last update date is 2018-10-12.
Shawnee Health Service And Development Corp's current location address is 109 California St, Carterville, Illinois. You can contact this provider via phone number 6189858221 and fax number 6189856860. The mailing address for Shawnee Health Service And Development Corp is 109 California St, Carterville, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Shawnee Health Service And Development Corp |
|---|---|
| Address | 109 California St, Carterville, Illinois |
| Phone Number | 6189858221 |
| Fax Number | 6189856860 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Jensen Patsy |
| Telephone Number | 6189569508 |
NPI Number Detail
| NPI Number | 1326079245 |
|---|---|
| Provider Enumeration Date | 2006-07-06 |
| Last Updated Date | 2018-10-12 |
Provider Mailing Address Detail
| Address | 109 California St |
|---|---|
| City | Carterville |
| State | Illinois (IL) |
| Post Code | 629180577 |
| Phone Number | 6189858221 |
| Fax Number | 6189856860 |
Provider's Primary Taxonomy Detail
| Speciality | Federally Qualified Health Center (fqhc) |
|---|---|
| Taxonomy | 261Qf0400X |
|
Definition: Provides primary and preventive care services in underserved areas, receiving certain federal funding grants. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 640702 | MEDICARE GROUP NUMBER |
Post Comment/ Review Below
What is the Shawnee Health Service And Development Corp's 1326079245?
The Shawnee Health Service And Development Corp's NPI (National Provider Identifier) Number is 1326079245. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Shawnee Health Service And Development Corp located?
The Shawnee Health Service And Development Corp is located at 109 California St, Carterville, IL 629180577.
What is Shawnee Health Service And Development Corp's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Shawnee Health Service And Development Corp is Federally Qualified Health Center (fqhc), and the taxonomy code that categorizes this field of expertise is 261Qf0400X.
On what date did the Centers for Medicare & Medicaid Services assign the 1326079245 to Shawnee Health Service And Development Corp?
The Centers for Medicare & Medicaid Services assigned the 1326079245 to Shawnee Health Service And Development Corp on 2006-07-06.
When was the information related to Shawnee Health Service And Development Corp most recently updated or refreshed?
The details pertaining to the Shawnee Health Service And Development Corp, including its address, specialty, and other relevant information, were last updated or refreshed on 2018-10-12.
NPI Number: 1588667679
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