# GRANITE CITY ILLINOIS HOSPITAL COMPANY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gateway Regional Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083685986
- **Authorized official:** TARA PEEK RICHARDSON (VP OF PATIENT FINANCIAL SERVICES)
- **Authorized official phone:** (615) 221-3672

## Contact information

- **Practice address:** 2100 MADISON AVE, GRANITE CITY, IL 62040-4701
- **Practice address phone:** (618) 798-3000
- **Practice address fax:** (618) 798-3724
- **Mailing address:** PO BOX 503706, ST. LOUIS, MO 63150-3706

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 273R00000X | Psychiatric Hospital Unit | 0005223 | IL | — |
| 282N00000X | General Acute Care Hospital | 0005223 | IL | Yes |

## Other

- **Enumeration date:** 01/30/2006
- **Last updated:** 05/07/2018