MASON HOSPITAL DISTRICT NPI 1063478782

NPI Information

NPI: 1063478782
Provider Name: MASON HOSPITAL DISTRICT

Doing Business As: HAVANA MEDICAL ASSOCIATES

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

Specialization: Rural Health

Address:
615 N PROMENADE ST
HAVANA, IL
ZIP 62644
Phone: (309) 543-6600
Get Directions

MASON HOSPITAL DISTRICT is a rural health clinic center in Havana, IL. MASON HOSPITAL DISTRICT NPI is 1063478782. The provider is registered as an organization entity type.
The provider Is Doing Business As Havana Medical Associates.

The provider's business location address is:

615 N PROMENADE ST
HAVANA, IL
ZIP 62644-243
Phone: (309) 543-6600
Fax: (309) 543-2089

The provider's authorized official is Mary L Layton .
The authorized official title is Director Of Clinic Operations and has the following contact phone number (309) 543-8542.

The CLIA number assigned to this NPI record is 14D0724597 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/21/2006 and was last updated on 2/2/2012.

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		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	143457	MEDICARE OSCAR/CERTIFICATION	ILLINOIS

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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