Organization
INDEPENDENT ORDER OF ODD FELLOWS
Active
Other names
Odd Fellow Rebekah Home
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID UNDERWOOD CPA (EXEC VP, CFO)
(309) 823-7135
Entity
Organization
Contact information
Practice address
201 LAFAYETTE AVE E, MATTOON, IL 61938-4641
(217) 235-5449
(217) 235-0611
Mailing address
115 W JEFFERSON ST, SUITE 401, BLOOMINGTON, IL 61701-3946
(309) 828-4361
(309) 829-5477
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
11/19/2012
Last updated
01/11/2018
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