Provider Demographics
NPI:1649668575
Name:SARAH BUSH LINCOLN HEALTH CENTER
Entity type:Organization
Organization Name:SARAH BUSH LINCOLN HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE AND OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-258-2571
Mailing Address - Street 1:910 S VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IL
Mailing Address - Zip Code:62448-1727
Mailing Address - Country:US
Mailing Address - Phone:618-783-3800
Mailing Address - Fax:618-783-5070
Practice Address - Street 1:910 S VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IL
Practice Address - Zip Code:62448-1727
Practice Address - Country:US
Practice Address - Phone:618-783-3800
Practice Address - Fax:618-783-5070
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SARAH BUSH LINCOLN HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-30
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health