Organization
FRANKLIN HOSPITAL DISTRICT
Active
Other names
West Frankfort Family Healthcare Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM JOHNSON (CEO)
(618) 439-3161
Entity
Organization
Contact information
Practice address
309 W SAINT LOUIS ST STE B, WEST FRANKFORT, IL 62896-2047
(618) 932-2200
(618) 932-2202
Mailing address
201 BAILEY LN, BENTON, IL 62812-1969
(618) 439-3161
(618) 439-9171
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
0005231
IL
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209232
MEDICARE P-TAN PROFESSIONAL FEE
IL
Enumeration date
05/14/2010
Last updated
03/19/2019
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