Organization
ST. MARY'S HOSPITAL
Active
Parent organization
ST. MARY'S HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. MARY'S HOSPITAL
Authorized official
MR. BRUCE MERRELL (PRESIDENT)
(618) 436-6205
Entity
Organization
Contact information
Practice address
825 NEW YORK DR, STE 2, VANDALIA, IL 62471-1044
(618) 283-0600
Mailing address
PO BOX 503861, SAINT LOUIS, MO 63150-0001
(618) 436-8000
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
0002642
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
259114
HEALTHLINK
IL
01
—
2620625
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/10/2005
Last updated
04/20/2008
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