Provider Demographics
NPI:1760940860
Name:PANA COMMUNITY HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:PANA COMMUNITY HOSPITAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-562-2143
Mailing Address - Street 1:217 S LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:PANA
Mailing Address - State:IL
Mailing Address - Zip Code:62557-1605
Mailing Address - Country:US
Mailing Address - Phone:217-562-2143
Mailing Address - Fax:217-562-2251
Practice Address - Street 1:217 S LOCUST ST
Practice Address - Street 2:
Practice Address - City:PANA
Practice Address - State:IL
Practice Address - Zip Code:62557-1689
Practice Address - Country:US
Practice Address - Phone:217-562-2143
Practice Address - Fax:217-562-2251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health