Organization
RED BUD ILLINOIS HOSPITAL COMPANY LLC
Active
Organization
RED BUD ILLINOIS HOSPITAL COMPANY LLC
Active
Other names
Red Bud Regional Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY MICHAEL COOPER (SVP FINANCE OP/AUTHORIZED OFFICIAL)
(615) 221-3840
Entity
Organization
Contact information
Practice address
325 SPRING ST, RED BUD, IL 62278-1105
(618) 282-3831
Mailing address
PO BOX 503891, SAINT LOUIS, MO 63150-3891
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
0005199
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003560
HEALTH ALLIANCE
—
01
—
012793
BC MO
—
01
—
105775
HEALTHLINK
—
01
—
43183
GROUP HEALTH PLAN
—
01
—
50021
BCBS
—
01
—
5007007
UNITED HEALTHCARE
—
Enumeration date
02/01/2006
Last updated
08/11/2020
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