Southern Illinois Regional Wellness Center in East Saint Louis - Federally Qualified Health Center (fqhc)
Southern Illinois Regional Wellness Center - NPI 1336258540
Southern Illinois Regional Wellness Center is a Federally Qualified Health Center (fqhc) in East Saint Louis, Illinois. Southern Illinois Regional Wellness Center practices all healthcare services and medical treatments related to Federally Qualified Health Center (fqhc). The NPI Number for Southern Illinois Regional Wellness Center is 1336258540. The last update date is 2016-07-06.
Southern Illinois Regional Wellness Center's current location address is 1736 Kingshighway, East Saint Louis, Illinois. You can contact this provider via phone number 6188743120 and fax number 6182154048. The mailing address for Southern Illinois Regional Wellness Center is 1736 Kingshighway, East Saint Louis, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Southern Illinois Regional Wellness Center |
|---|---|
| Address | 1736 Kingshighway, East Saint Louis, Illinois |
| Phone Number | 6188743120 |
| Fax Number | 6182154048 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | EXECUTIVE |
|---|---|
| Authorized Official Name | Freeland R Mark |
| Telephone Number | 6188743120 |
NPI Number Detail
| NPI Number | 1336258540 |
|---|---|
| Provider Enumeration Date | 2006-08-30 |
| Last Updated Date | 2016-07-06 |
Provider Mailing Address Detail
| Address | 1736 Kingshighway |
|---|---|
| City | East Saint Louis |
| State | Illinois (IL) |
| Post Code | 622042134 |
| Phone Number | 6188743120 |
| Fax Number | 6182154048 |
Provider's Primary Taxonomy Detail
| Speciality | Federally Qualified Health Center (fqhc) |
|---|---|
| Taxonomy | 261Qf0400X |
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Definition: Provides primary and preventive care services in underserved areas, receiving certain federal funding grants. |
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What is the Southern Illinois Regional Wellness Center's 1336258540?
The Southern Illinois Regional Wellness Center's NPI (National Provider Identifier) Number is 1336258540. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Southern Illinois Regional Wellness Center located?
The Southern Illinois Regional Wellness Center is located at 1736 Kingshighway, East Saint Louis, IL 622042134.
What is the area of specialization for Southern Illinois Regional Wellness Center, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Southern Illinois Regional Wellness Center is Federally Qualified Health Center (fqhc), and the corresponding taxonomy code that categorizes this area of expertise is 261Qf0400X.
On what date did the Centers for Medicare & Medicaid Services issue the 1336258540 to Southern Illinois Regional Wellness Center?
The Southern Illinois Regional Wellness Center received its 1336258540 assignment from the Centers for Medicare & Medicaid Services on 2006-08-30.
As of what date were the details related to Southern Illinois Regional Wellness Center most recently updated or revised?
The information pertaining to Southern Illinois Regional Wellness Center, including its address, specialty, and other relevant details, was last updated or revised on 2016-07-06.