Memorial Physician Services

LBN: Memorial Physician Services
Memorial Physician Services is an health care organization with primary practice located at 1602 W Lafayette Ave , Jacksonville IL 62650-1007. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. Memorial Physician Services can be contacted via phone (217) 243-7200, or through Dowell, James T via phone (217) 788-3342.

Contact Information

Primary practice address
1602 W Lafayette Ave Jacksonville IL 62650-1007
Phone: (217) 243-7200
Fax: (217) 243-6165
Website:
Map and Directions
Authorized official contact:
Name: Dowell, James T
Phone: (217) 788-3342

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X

Profile Details

NPI number 1104179415
LBN Legal business name Memorial Physician Services
DBA Doing business as
Authorized official Dowell, James T
Entity Organization
Organization subpart 1 No
Enumeration date Oct 24th, 2012
Last updated Oct 26th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104179415 NPPES
Other 148906 RHC MEDICARE PTAN

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