Organization
PHYSICIAN SERVICES CORP OF SOUTHERN ILLINOIS
Active
Parent organization
PHYSICAN SEVICES CORP OF SOUTHERN ILLINOIS
Other names
St Marys Good samaritan Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHYSICAN SEVICES CORP OF SOUTHERN ILLINOIS
Authorized official
MR. RICHARD HUNTINGTON (VP FINANCIAL DEVELOPMENT)
(618) 241-2204
Entity
Organization
Contact information
Practice address
1250 W WHITTAKER ST, SALEM, IL 62881-1917
(618) 532-3950
(618) 532-9365
Mailing address
413 MAIN ST, MOUNT VERNON, IL 62864-3649
(618) 532-3950
(618) 532-9365
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/11/2009
Last updated
08/11/2009
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