Organization
LAWRENCE COUNTY MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD H KLEIN (CFO)
(618) 943-7202
Entity
Organization
Contact information
Practice address
2200 STATE ST, LAWRENCEVILLE, IL 62439-1852
(618) 943-7249
(618) 943-7223
Mailing address
2200 STATE ST, LAWRENCEVILLE, IL 62439-1852
(618) 943-7249
(618) 943-7223
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
0001255
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376001199001
—
IL
05
—
376001199401
—
IL
Enumeration date
09/25/2006
Last updated
02/16/2011
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