Shawnee Health Care, Carbondale Dental

LBN: Shawnee Health Service & Development Corp
Shawnee Health Care, Carbondale Dental is an health care organization with primary practice located at 402 S. Lewis Lane , Carbondale IL 62901. The organization recently has 5 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry, Dental Providers / Dental Hygienist, Dental Providers / Dental Assistant, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. Shawnee Health Service & Development Corp can be contacted via phone (618) 519-9901, or through Carney, Christina via phone (618) 956-9521.

Contact Information

Primary practice address
402 S. Lewis Lane Carbondale IL 62901
Phone: (618) 519-9901
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Carney, Christina
Phone: (618) 956-9521

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X Illinois
Dental Providers / Pediatric Dentistry 1223P0221X Illinois
Dental Providers / Dental Hygienist 124Q00000X Illinois
Dental Providers / Dental Assistant 126800000X Illinois
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X

Profile Details

NPI number 1174859870
LBN Legal business name Shawnee Health Service & Development Corp
DBA Doing business as Shawnee Health Care, Carbondale Dental
Authorized official Carney, Christina
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 30th, 2009
Last updated Apr 4th, 2024 - about last year

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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1174859870 NPPES
Illinois MEDICAID 019028144
Illinois MEDICAID 019027984
Illinois MEDICAID 019028085
Illinois MEDICAID 019028089
Illinois MEDICAID 019028149
Illinois MEDICAID 019028752

Popular Providers