Koch Health Center
LBN: Southern Illinois Healthcare Foundation, Inc
Koch Health Center is an health care organization with primary practice located at 2100 Madison Ave , Granite City IL 62040-4701. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Pediatrics, 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) 452-3301, or through Mcculley, Larry via phone (618) 332-0783.
Contact Information
Primary practice address
2100 Madison Ave
Granite City IL 62040-4701
Phone: (618) 452-3301
Fax: (618) 452-3312
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | ||
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ||
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X |
Profile Details
| NPI number | 1801822010 |
|---|---|
| LBN Legal business name | Southern Illinois Healthcare Foundation, Inc |
| DBA Doing business as | Koch Health Center |
| Authorized official | Mcculley, Larry |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 23rd, 2006 |
| Last updated | Apr 20th, 2008 - about 16 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 | 1801822010 | NPPES |
| Illinois | Other | 732740 | WPS MEDICARE GROUP NUMBER |
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