Organization
LAWRENCE COUNTY MEMORIAL HOSPITAL
Active
Parent organization
LAWRENCE COUNTY MEMORIAL HOSPITAL
Other names
PRIMARY CARE CLINIC, LCMH PRIMARY CARE CLINIC-RHC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAWRENCE COUNTY MEMORIAL HOSPITAL
Authorized official
JOSEY JOHNSON (PROJECT COORD)
(405) 371-9756
Entity
Organization
Contact information
Practice address
2111 LEXINGTON AVE, LAWRENCEVILLE, IL 62439-2085
(618) 943-7216
(618) 943-7219
Mailing address
2111 LEXINGTON AVE, LAWRENCEVILLE, IL 62439-2085
(618) 943-1000
(618) 943-7219
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881643401
LCMH PART A NPI 1881643401 - 141344
—
Enumeration date
09/14/2007
Last updated
10/27/2022
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