PENNY ATTAWAY NPI 1528185170

NPI Information

NPI: 1528185170
Provider Name: PENNY ATTAWAY

Doing Business As: MEDICAL SERVICS UNLIMITED

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

Specialization: Rural Health

Address:
1404 N 5TH ST
VANDALIA, IL
ZIP 62471
Phone: (618) 283-2000
Get Directions

PENNY ATTAWAY is a rural health clinic center in Vandalia, IL. PENNY ATTAWAY NPI is 1528185170. The provider is registered as an organization entity type.
The provider Is Doing Business As Medical Servics Unlimited.

The provider's business location address is:

1404 N 5TH ST
VANDALIA, IL
ZIP 62471-039
Phone: (618) 283-2000
Fax: (618) 283-2002

The provider's authorized official is Penny Attaway .
The authorized official title is Dnp and has the following contact phone number (618) 971-1440.

The CLIA number assigned to this NPI record is 14D2107698 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/26/2007 and was last updated on 12/20/2016.

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	209001693	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	783833	MEDICARE PIN	ILLINOIS
2	=========003	MEDICAID	ILLINOIS
3	F300273890	MEDICARE PIN	ILLINOIS
4	L040233	OTHER	ILLINOIS	TRICARE

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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