Provider Demographics
NPI:1376671800
Name:GALLATIN CTY SCHOOL HEALTH CTR NFP
Entity Type:Organization
Organization Name:GALLATIN CTY SCHOOL HEALTH CTR NFP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-273-3326
Mailing Address - Street 1:5150 HIGHWAY 13
Mailing Address - Street 2:
Mailing Address - City:JUNCTION
Mailing Address - State:IL
Mailing Address - Zip Code:62954-2118
Mailing Address - Country:US
Mailing Address - Phone:618-272-7132
Mailing Address - Fax:618-272-7064
Practice Address - Street 1:5150 HIGHWAY 13
Practice Address - Street 2:
Practice Address - City:JUNCTION
Practice Address - State:IL
Practice Address - Zip Code:62954-2118
Practice Address - Country:US
Practice Address - Phone:618-272-7132
Practice Address - Fax:618-272-7064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty