ST. MARY'S HOSPITAL NPI 1790789451

NPI Information

NPI: 1790789451
Provider Name: ST. MARY'S HOSPITAL
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
825 NEW YORK DR
STE 2
VANDALIA, IL
ZIP 62471
Phone: (618) 283-0600
Get Directions

ST. MARY'S HOSPITAL is a rural health clinic center in Vandalia, IL. ST. MARY'S HOSPITAL NPI is 1790789451. The provider is registered as an organization entity type.

The provider's business location address is:

825 NEW YORK DR
STE 2
VANDALIA, IL
ZIP 62471-044
Phone: (618) 283-0600

The provider's authorized official is Bruce Merrell .
The authorized official title is President and has the following contact phone number (618) 436-6205.

The enumeration date for this NPI number is 6/10/2005 and was last updated on 4/20/2008.

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	0002642	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	259114	OTHER	ILLINOIS	HEALTHLINK
2	=========005	MEDICAID	ILLINOIS
3	=========002	OTHER	ILLINOIS	TRICARE
4	143409	MEDICARE OSCAR/CERTIFICATION	ILLINOIS
5	2620625	OTHER	ILLINOIS	BLUE CROSS BLUE SHIELD

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

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