Organization
PROTESTANT MEMORIAL MEDICAL CENTER, INC.
Active
Other names
Memorial Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANE GUSMANO (VICE PRESIDENT)
(618) 257-5606
Entity
Organization
Contact information
Practice address
4315 MEMORIAL DR, BELLEVILLE, IL 62226-5342
(618) 257-5060
(618) 257-6940
Mailing address
4315 MEMORIAL DR, BELLEVILLE, IL 62226-5342
(618) 257-5060
(618) 257-6940
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0003103
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390635502002
—
IL
Enumeration date
10/04/2006
Last updated
06/09/2022
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