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Organization
NATIONAL HEALTHCARE OF MT VERNON INC
Active
Organization
NATIONAL HEALTHCARE OF MT VERNON INC
Active
Other names
Crossroads Family Medicine of Benton
Organization subpart
No
Provider details
NPI number
Authorized official
TARA P RICHARDSON (AUTHORIZED OFFICIAL)
(615) 221-3672
Entity
Organization
Contact information
Practice address
905 W WASHINGTON ST STE A, BENTON, IL 62812
(618) 435-2229
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(800) 709-7338
(615) 469-6505
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
0003947
IL
Other
Enumeration date
09/19/2012
Last updated
04/23/2019
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