Organization
SOUTHERN ILLINOIS MEDICAL SERVICES, NFP
Active
Parent organization
SOUTHERN ILLINOIS HOSPITAL SERVICES
Other names
Benton Community Healthcare
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN ILLINOIS HOSPITAL SERVICES
Authorized official
MR. REX P BUDDE (CHIEF EXECUTIVE OFFICER)
(618) 457-5200
Entity
Organization
Contact information
Practice address
203 BAILEY LN, BENTON, IL 62812-1969
(618) 438-5670
(618) 438-5709
Mailing address
203 BAILEY LN, BENTON, IL 62812-1969
(618) 438-5670
(618) 438-5709
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XXXXXXXXX002
—
IL
Enumeration date
03/18/2009
Last updated
03/18/2009
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