Organization
NATIONAL HEALTHCARE OF MT VERNON INC
Active
Other names
Crossroads Community Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY MICHAEL COOPER (SVP FINANCE OPERATIONS/AO)
(615) 221-3840
Entity
Organization
Contact information
Practice address
8 DOCTORS PARK RD, MOUNT VERNON, IL 62864-6224
(618) 244-5500
(618) 244-5566
Mailing address
PO BOX 60548, SAINT LOUIS, MO 63160-0548
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
0003947
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011701901
—
MO
01
—
131
BCBS
—
01
—
288089
HEALTHLINK
—
01
—
614753
BOILERMAKERS
—
Enumeration date
02/02/2006
Last updated
09/03/2020
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