Southside Medical Clinic Inc

LBN: Southside Medical Clinic Inc
Southside Medical Clinic Inc is an health care organization with primary practice located at 913 South 10Th Street , Mount Vernon IL 62864-5313. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. Southside Medical Clinic Inc can be contacted via phone (618) 242-2745, or through Melvin, Bruce Wayne via phone (618) 242-2745.

Contact Information

Primary practice address
913 South 10Th Street Mount Vernon IL 62864-5313
Phone: (618) 242-2745
Fax: (618) 242-2766
Website:
Map and Directions
Authorized official contact:
Name: Melvin, Bruce Wayne
Phone: (618) 242-2745

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X 001 Illinois

Profile Details

NPI number 1497823314
LBN Legal business name Southside Medical Clinic Inc
DBA Doing business as
Authorized official Melvin, Bruce Wayne
Entity Organization
Organization subpart 1 No
Enumeration date Nov 30th, 2006
Last updated Jul 21st, 2022 - about 3 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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