Organization
RICHLAND MEMORIAL HOSPITAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARRY BROCKUS (CEO)
(217) 283-8540
Entity
Organization
Contact information
Practice address
800 E LOCUST ST, OLNEY, IL 62450-2553
(618) 395-7340
Mailing address
800 E LOCUST ST, OLNEY, IL 62450-2553
(618) 395-7340
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08022315
BLUE SHIELD PROVIDER NUMB
IL
01
—
283653
HEALTHLINK PRO FEE PROVID
IL
01
—
L041056
TRICARE PRO FEE PROVIDER
IL
Enumeration date
11/27/2006
Last updated
05/09/2018
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