Provider Demographics
NPI:1255460440
Name:PANA COMMUNITY HOSPTIAL ASSOCIATION
Entity type:Organization
Organization Name:PANA COMMUNITY HOSPTIAL ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASNER
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:217-562-2131
Mailing Address - Street 1:107 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:NOKOMIS
Mailing Address - State:IL
Mailing Address - Zip Code:62075-1499
Mailing Address - Country:US
Mailing Address - Phone:217-563-8343
Mailing Address - Fax:217-563-2285
Practice Address - Street 1:107 W STATE ST
Practice Address - Street 2:
Practice Address - City:NOKOMIS
Practice Address - State:IL
Practice Address - Zip Code:62075-1499
Practice Address - Country:US
Practice Address - Phone:217-563-8343
Practice Address - Fax:217-563-2285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty