Organization
MIDWEST CARE VANDALIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD KANG (VP OF ACCOUNTING AND FINANCE)
(541) 747-3373
Entity
Organization
Contact information
Practice address
1607 W FILLMORE ST, VANDALIA, IL 62471-3112
(618) 283-9825
Mailing address
78 CENTENNIAL LOOP, EUGENE, OR 97401-7900
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
09/24/2009
Last updated
09/24/2009
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