Provider Demographics
NPI: | 1629280367 |
---|---|
Name: | HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC |
Entity Type: | Organization |
Organization Name: | HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC |
Other - Org Name: | HORIZON HEALTH |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | VP OF FINANCE & CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MARTIN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ADAMS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 217-466-4246 |
Mailing Address - Street 1: | 721 E COURT ST |
Mailing Address - Street 2: | |
Mailing Address - City: | PARIS |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 61944-2460 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 174-654-1412 |
Mailing Address - Fax: | 217-465-5615 |
Practice Address - Street 1: | 721 E COURT ST |
Practice Address - Street 2: | |
Practice Address - City: | PARIS |
Practice Address - State: | IL |
Practice Address - Zip Code: | 61944-2460 |
Practice Address - Country: | US |
Practice Address - Phone: | 217-465-4141 |
Practice Address - Fax: | 217-465-5615 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2007-05-04 |
Last Update Date: | 2024-03-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QR1300X | Ambulatory Health Care Facilities | Clinic/Center | Rural Health | Group - Multi-Specialty |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty | |
No | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | Group - Multi-Specialty |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
No | 208VP0000X | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | Group - Multi-Specialty |
No | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Group - Multi-Specialty | |
No | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
IL | 2315368 | Other | BLUE CROSS BLUE SHIELD |
IL | 532960 | Medicare PIN | |
IL | 2315368 | Other | BLUE CROSS BLUE SHIELD |