Organization
SPARTA COMMUNITY HOSPITAL D/B/A QUALITY HEALTHCARE CLINICS
Active
Other names
Coulterville Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA ERNSTING (CFO)
(618) 443-2177
Entity
Organization
Contact information
Practice address
203 E GRANT ST, COULTERVILLE, IL 62237-1623
(618) 758-2331
(618) 758-2819
Mailing address
PO BOX 297, SPARTA, IL 62286-0297
(618) 443-1337
(618) 443-1383
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143465
RHC PROVIDER LOCATION NUM
IL
Enumeration date
08/23/2006
Last updated
05/16/2023
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