Provider Demographics
NPI:1235790940
Name:RICHLAND MEMORIAL HOSPITAL, INC
Entity Type:Organization
Organization Name:RICHLAND MEMORIAL HOSPITAL, INC
Other - Org Name:THE APOTHECARY SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR BUSINESS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-395-6073
Mailing Address - Street 1:800 E LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:IL
Mailing Address - Zip Code:62450-2553
Mailing Address - Country:US
Mailing Address - Phone:618-395-7340
Mailing Address - Fax:
Practice Address - Street 1:108 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST SALEM
Practice Address - State:IL
Practice Address - Zip Code:62476-1202
Practice Address - Country:US
Practice Address - Phone:618-456-3716
Practice Address - Fax:618-456-2029
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CARLE FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy