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Organization
FAYETTE COUNTY
Active
Organization
FAYETTE COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA ANDREWS (ADMINISTRATOR)
(618) 283-1044
Entity
Organization
Contact information
Practice address
509 W EDWARDS ST, VANDALIA, IL 62471-2707
(618) 283-1044
Mailing address
509 W EDWARDS ST, VANDALIA, IL 62471-2707
(618) 283-1044
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
NULL
Other
Enumeration date
05/15/2008
Last updated
11/05/2009
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