Organization
CARBONDALE RURAL HEALTH CLINIC
Active
Parent organization
CARBONDALE CLINIC, S. C
Organization subpart
Yes
Provider details
NPI number
Legal business name
CARBONDALE CLINIC, S. C
Authorized official
MR. ALLAN N NORMAN (CHIEF EXECUTIVE OFFICER)
(618) 549-5361
Entity
Organization
Contact information
Practice address
2601 W MAIN ST, CARBONDALE, IL 62901-1031
(618) 549-5361
(618) 549-5128
Mailing address
2601 W MAIN ST, CARBONDALE, IL 62901-1031
(618) 549-5361
(618) 549-5128
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/28/2006
Last updated
04/20/2008
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