Organization
COUNTY OF SCOTT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE SHIREMAN (ADMINISTRATOR)
(217) 742-8203
Entity
Organization
Contact information
Practice address
335 W CHERRY ST, WINCHESTER, IL 62694-1029
(217) 742-8203
(217) 742-8304
Mailing address
335 W CHERRY ST, WINCHESTER, IL 62694-1029
(217) 742-8203
(217) 742-8304
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
240000171001
—
IL
Enumeration date
01/19/2007
Last updated
02/11/2013
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