Organization
GRANITE CITY ILLINOIS HOSPITAL COMPANY LLC
Active
Parent organization
GRANITE CITY ILLINOIS HOSPITAL COMPANY LLC
Other names
Gateway Regional Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRANITE CITY ILLINOIS HOSPITAL COMPANY LLC
Authorized official
TARA P RICHARDSON (AUTHORIZED OFFICIAL)
(615) 221-3672
Entity
Organization
Contact information
Practice address
2100 MADISON AVE, GRANITE CITY, IL 62040-4701
(618) 798-3000
(618) 798-3724
Mailing address
PO BOX 503706, SAINT LOUIS, MO 63150-3706
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1010199
IL
Other
Enumeration date
01/30/2006
Last updated
04/26/2016
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