Provider Demographics
NPI:1528188224
Name:MORRISON COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:MORRISON COMMUNITY HOSPITAL
Other - Org Name:MORRISON FAMILY CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASST. ADMIN
Authorized Official - Prefix:MS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PFISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-772-5530
Mailing Address - Street 1:303 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:IL
Mailing Address - Zip Code:61270-3042
Mailing Address - Country:US
Mailing Address - Phone:815-772-5530
Mailing Address - Fax:815-772-7391
Practice Address - Street 1:303 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:MORRISON
Practice Address - State:IL
Practice Address - Zip Code:61270-3042
Practice Address - Country:US
Practice Address - Phone:815-772-5530
Practice Address - Fax:815-772-7391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0001616282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========004Medicaid