Organization
SALEM TOWNSHIP HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES TIMPE (PRESIDENT/CEO/CFO)
(618) 548-3194
Entity
Organization
Contact information
Practice address
1201 RICKER DRIVE, SALEM, IL 62881
(618) 548-3194
(618) 548-6831
Mailing address
1201 RICKER DRIVE, SALEM, IL 62881
(618) 548-3194
(618) 548-6831
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
0002089
IL
282NC0060X
Critical Access Hospital
Primary
0002089
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6115213
BLUE SHIELD
ID
Enumeration date
12/05/2006
Last updated
08/01/2024
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