Provider Demographics
NPI:1245392349
Name:BLESSING HOSPITAL
Entity Type:Organization
Organization Name:BLESSING HOSPITAL
Other - Org Name:EAST ADAMS COUNTY RURAL HEALTH CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-223-1200
Mailing Address - Street 1:102 PRAIRE MILLS ROAD
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:IL
Mailing Address - Zip Code:62339
Mailing Address - Country:US
Mailing Address - Phone:217-696-4446
Mailing Address - Fax:217-696-4388
Practice Address - Street 1:102 PRAIRE MILLS ROAD
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:IL
Practice Address - Zip Code:62339
Practice Address - Country:US
Practice Address - Phone:217-696-4446
Practice Address - Fax:217-696-4388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL143422Medicare ID - Type Unspecified