Provider Demographics
NPI:1992020499
Name:CARLINVILLE AREA HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:CARLINVILLE AREA HOSPITAL ASSOCIATION
Other - Org Name:CARLINVILLE FAMILY HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:COURTNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-854-3141
Mailing Address - Street 1:20613 N BROAD ST STE B
Mailing Address - Street 2:
Mailing Address - City:CARLINVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62626-3721
Mailing Address - Country:US
Mailing Address - Phone:217-854-3881
Mailing Address - Fax:217-854-3894
Practice Address - Street 1:20613 N BROAD ST STE B
Practice Address - Street 2:
Practice Address - City:CARLINVILLE
Practice Address - State:IL
Practice Address - Zip Code:62626-3721
Practice Address - Country:US
Practice Address - Phone:217-854-3881
Practice Address - Fax:217-854-3894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-29
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health