Organization
LAWRENCE COUNTY MEMORIAL HOSPITAL
Active
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 62439-1899
(618) 943-1000
Mailing address
2200 STATE ST, LAWRENCEVILLE, IL 62439-1899
(618) 943-1000
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
0005769
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005219
HEALTH ALLIANCE
—
05
—
100069690A
—
IN
01
—
108986
HEALTHLINK
—
01
—
5115002
BLUE CROSS
IL
01
—
CG7133
RAILROAD MEDICARE ID
IL
Enumeration date
08/11/2011
Last updated
12/08/2022
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