Organization
COUNTRY HEALTH, INC
Active
Other names
Country Health Care & Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID UNDERWOOD CPA (EXEC VP, CFO)
(309) 823-7135
Entity
Organization
Contact information
Practice address
2304 COUNTRY ROAD 3000 NORTH, GIFFORD, IL 61847-9756
(217) 568-7362
(217) 568-7314
Mailing address
115 W JEFFERSON ST, SUITE 401, BLOOMINGTON, IL 61701-3946
(309) 828-4361
(309) 829-5477
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
11/20/2012
Last updated
10/18/2016
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