# LAWRENCE COUNTY MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LAWRENCE COUNTY MEMORIAL HOSPITAL
- **Other names:** PRIMARY CARE CLINIC, LCMH PRIMARY CARE CLINIC-RHC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1811183692
- **Legal business name:** LAWRENCE COUNTY MEMORIAL HOSPITAL
- **Authorized official:** JOSEY JOHNSON (PROJECT COORD)
- **Authorized official phone:** (405) 371-9756

## Contact information

- **Practice address:** 2111 LEXINGTON AVE, LAWRENCEVILLE, IL 62439-2085
- **Practice address phone:** (618) 943-7216
- **Practice address fax:** (618) 943-7219
- **Mailing address:** 2111 LEXINGTON AVE, LAWRENCEVILLE, IL 62439-2085
- **Mailing address phone:** (618) 943-1000
- **Mailing address fax:** (618) 943-7219

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/14/2007
- **Last updated:** 10/27/2022