Good Samaritan Health Center
LBN: Southern Illinois Healthcare Foundation, Inc.
Good Samaritan Health Center is an health care organization with primary practice located at 815 E 5Th St , Alton IL 62002-6471. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty.
Southern Illinois Healthcare Foundation, Inc. can be contacted via phone (618) 397-3303, or through Mcculley, Larry via phone (618) 332-0694.
Contact Information
Primary practice address
815 E 5Th St
Alton IL 62002-6471
Phone: (618) 397-3303
Fax: (618) 397-7802
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X |
Profile Details
| NPI number | 1346402062 |
|---|---|
| LBN Legal business name | Southern Illinois Healthcare Foundation, Inc. |
| DBA Doing business as | Good Samaritan Health Center |
| Authorized official | Mcculley, Larry |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 25th, 2008 |
| Last updated | Jul 22nd, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346402062 | NPPES |
| Illinois | Other | 732740 | WPS MEDICARE PART B |
| Illinois | Other | 14-1089 | WPS MEDICARE PART B |
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