Organization
GRANITE CITY ILLINOIS HOSPITAL COMPANY LLC
Active
Parent organization
GRANITE CITY ILLINOIS HOSPITAL COMPANY LLC
Other names
Gateway Regional Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRANITE CITY ILLINOIS HOSPITAL COMPANY LLC
Authorized official
RANDY MICHAEL COOPER (SVP FINANCE OPERATIONS)
(615) 221-3840
Entity
Organization
Contact information
Practice address
2100 MADISON AVE, GRANITE CITY, IL 62040-4701
(618) 798-3000
(618) 798-3724
Mailing address
PO BOX 503706, SAINT LOUIS, MO 63150-3706
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
0005223
IL
Other
Enumeration date
01/30/2006
Last updated
09/03/2020
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