Provider Demographics
NPI:1235182874
Name:SCHUYLER COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:SCHUYLER COUNTY HOSPITAL DISTRICT
Other - Org Name:ELMER HUGH TAYLOR CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GADBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-322-4321
Mailing Address - Street 1:100 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BEARDSTOWN
Mailing Address - State:IL
Mailing Address - Zip Code:62618-1701
Mailing Address - Country:US
Mailing Address - Phone:217-323-2245
Mailing Address - Fax:217-323-1276
Practice Address - Street 1:100 W 15TH ST
Practice Address - Street 2:
Practice Address - City:BEARDSTOWN
Practice Address - State:IL
Practice Address - Zip Code:62618-1701
Practice Address - Country:US
Practice Address - Phone:217-323-2245
Practice Address - Fax:217-323-1276
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCHUYLER COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-17
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL143483Medicare Oscar/Certification