Provider Demographics
NPI:1134370356
Name:SCHUYLER COUNTY HOSPITAL DISTRICT HEALTH CENTER INC
Entity type:Organization
Organization Name:SCHUYLER COUNTY HOSPITAL DISTRICT HEALTH CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICIER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SNIFF
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:217-322-4321
Mailing Address - Street 1:507 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BEARDSTOWN
Mailing Address - State:IL
Mailing Address - Zip Code:62618-1558
Mailing Address - Country:US
Mailing Address - Phone:217-323-2245
Mailing Address - Fax:217-323-1276
Practice Address - Street 1:507 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BEARDSTOWN
Practice Address - State:IL
Practice Address - Zip Code:62618-1558
Practice Address - Country:US
Practice Address - Phone:217-323-2245
Practice Address - Fax:217-323-1276
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCHUYLER COUNTY HOSPITAL DISTRICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL639771Medicare PIN