Organization
CARLINVILLE AREA HOSPITAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN D. BURNSIDE (CEO)
(217) 854-3141
Entity
Organization
Contact information
Practice address
20733 N BROAD ST, CARLINVILLE, IL 62626-1499
(217) 854-3141
(217) 854-9958
Mailing address
20733 N BROAD ST, CARLINVILLE, IL 62626-3710
(217) 854-3141
(217) 854-9958
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
0000182
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8415054
BLUE SHIELD PROVIDER NUMB
IL
Enumeration date
04/12/2007
Last updated
03/18/2025
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