Organization
MEMORIAL HOSPITAL OF CARBONDALE
Active
Parent organization
SIH
Organization subpart
Yes
Provider details
NPI number
Legal business name
SIH
Authorized official
MRS. AMY MARIE SURBURG ANP-BC (NURSE PRACTITIONER, PRE-ANESTHESIA)
(618) 549-0721
Entity
Organization
Contact information
Practice address
405 W JACKSON ST, CARBONDALE, IL 62901-1462
(618) 549-0721
(618) 529-0431
Mailing address
405 W JACKSON ST, CARBONDALE, IL 62901-1462
(618) 549-0721
(618) 529-0431
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
209008246
IL
Other
Enumeration date
09/30/2010
Last updated
09/30/2010
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