Provider Demographics
NPI:1497314074
Name:HOOPESTON COMMUNITY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:HOOPESTON COMMUNITY MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROCKUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-283-8540
Mailing Address - Street 1:611 W PARK ST. - FAPC
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-2529
Mailing Address - Country:US
Mailing Address - Phone:217-383-6941
Mailing Address - Fax:
Practice Address - Street 1:701 E ORANGE ST
Practice Address - Street 2:
Practice Address - City:HOOPESTON
Practice Address - State:IL
Practice Address - Zip Code:60942-1801
Practice Address - Country:US
Practice Address - Phone:217-283-5531
Practice Address - Fax:217-283-7981
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CARLE FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy