Provider Demographics
NPI:1376676213
Name:HAMMOND HENRY HOSPITAL
Entity Type:Organization
Organization Name:HAMMOND HENRY HOSPITAL
Other - Org Name:EKG READING
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-944-6431
Mailing Address - Street 1:600 N COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:IL
Mailing Address - Zip Code:61254-1091
Mailing Address - Country:US
Mailing Address - Phone:309-944-6431
Mailing Address - Fax:
Practice Address - Street 1:600 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:GENESEO
Practice Address - State:IL
Practice Address - Zip Code:61254-1091
Practice Address - Country:US
Practice Address - Phone:309-944-6431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL803200Medicare ID - Type UnspecifiedEKG READ