Organization
MEMORIAL HOSPITAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADA M BAIR (CEO)
(217) 357-8566
Entity
Organization
Contact information
Practice address
1454 N COUNTY ROAD 2050, CARTHAGE, IL 62321-3551
(217) 357-8562
(217) 357-8564
Mailing address
PO BOX 160, CARTHAGE, IL 62321-0160
(217) 357-8500
(217) 357-6564
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
0005611
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010495307
—
MO
01
—
0199
BLUE CROSS
IL
05
—
0901017
—
IA
01
—
113150
HEALTHLINK
IL
01
—
3415003
BLUE SHIELD
IL
01
—
L012131
TRICARE
IL
Enumeration date
05/10/2006
Last updated
04/05/2019
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