Provider Demographics
NPI:1568005981
Name:GRAHAM HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:GRAHAM HOSPITAL ASSOCIATION
Other - Org Name:GRAHAM MEDICAL GROUP - SAUNDERS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE/ CFO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:REEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-647-5240
Mailing Address - Street 1:180 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:IL
Mailing Address - Zip Code:61520-2608
Mailing Address - Country:US
Mailing Address - Phone:309-647-0201
Mailing Address - Fax:309-647-8613
Practice Address - Street 1:1800 23RD AVE
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IL
Practice Address - Zip Code:61415-9126
Practice Address - Country:US
Practice Address - Phone:309-647-0201
Practice Address - Fax:309-647-8613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-18
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty