Organization
MEMORIAL HOME SERVICES OF CENTRAL ILLINOIS, INC
Active
Parent organization
MEMORIAL HOME SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEMORIAL HOME SERVICES
Authorized official
MS. LORI VALENTINE RN (DIRECTOR, DME)
(217) 788-4663
Entity
Organization
Contact information
Practice address
306 N WESTGATE AVE STE A, JACKSONVILLE, IL 62650-3713
(217) 788-4663
Mailing address
306 N WESTGATE AVE STE A, JACKSONVILLE, IL 62650-3713
(217) 788-4663
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
361190216013
—
IL
Enumeration date
08/12/2014
Last updated
05/02/2016
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