Provider Demographics
NPI:1821659616
Name:SOUTHERN ILLINOIS HOME MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:SOUTHERN ILLINOIS HOME MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHALTENBRAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-482-2002
Mailing Address - Street 1:911 WATER ST
Mailing Address - Street 2:
Mailing Address - City:CAHOKIA
Mailing Address - State:IL
Mailing Address - Zip Code:62206-1614
Mailing Address - Country:US
Mailing Address - Phone:618-482-2002
Mailing Address - Fax:618-215-0653
Practice Address - Street 1:911 WATER ST
Practice Address - Street 2:
Practice Address - City:CAHOKIA
Practice Address - State:IL
Practice Address - Zip Code:62206-1614
Practice Address - Country:US
Practice Address - Phone:618-482-2002
Practice Address - Fax:618-215-0653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies