Organization
COMWELL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY BAUER (IT COORDINATOR)
(618) 282-6233
Entity
Organization
Contact information
Practice address
10257 STATE ROUTE THREE, RED BUD, IL 62278
(618) 282-6233
(618) 282-6949
Mailing address
10257 STATE ROUTE 3, TRANSPORTATION, RED BUD, IL 62278
(618) 282-6233
(618) 282-6949
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
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PROVIDER KEY
—
Enumeration date
05/09/2007
Last updated
02/23/2021
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