# NATIONAL HEALTHCARE OF MT VERNON INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Crossroads Family Medicine of Mt Vernon
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962753277
- **Authorized official:** TARA P RICHARDSON (AUTHORIZED OFFICAL)
- **Authorized official phone:** (615) 221-3672

## Contact information

- **Practice address:** 209 CROSSROADS PL, SUITE 120, MOUNT VERNON, IL 62864-6545
- **Practice address phone:** (618) 244-6222
- **Practice address fax:** (618) 244-7299
- **Mailing address:** PO BOX 689022, FRANKLIN, TN 37068-9022
- **Mailing address phone:** (800) 709-7338
- **Mailing address fax:** (615) 469-6505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 0003947 | IL | Yes |

## Other

- **Enumeration date:** 09/26/2012
- **Last updated:** 04/25/2016