Provider Demographics
NPI:1447691571
Name:CARLINVILLE AREA HOSPITAL ASSOCIATION
Entity type:Organization
Organization Name:CARLINVILLE AREA HOSPITAL ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BURNSIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-854-3141
Mailing Address - Street 1:20733 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CARLINVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62626-3710
Mailing Address - Country:US
Mailing Address - Phone:217-854-3141
Mailing Address - Fax:
Practice Address - Street 1:1611 N SPRINGFIELD ST
Practice Address - Street 2:
Practice Address - City:VIRDEN
Practice Address - State:IL
Practice Address - Zip Code:62690
Practice Address - Country:US
Practice Address - Phone:217-854-3819
Practice Address - Fax:217-965-7113
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARLINVILLE AREA HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-17
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health