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2 Saint Anthonys Way Ste 101 Alton IL 62002-4580 | |
| (618) 332-0953 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2 Saint Anthonys Way Ste 101, Alton, Illinois |
| Authorized Official Name and Position | Larry Mcculley (PRESIDENT/CEO) |
| Authorized Official Contact | 6183320694 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2041 Goose Lake Rd Sauget IL 62206-2822 Ph: (618) 332-0953 | 2 Saint Anthonys Way Ste 101 Alton IL 62002-4580 Ph: (618) 332-0953 |
| NPI Number | 1427749845 |
|---|---|
| Provider Enumeration Date | 05/17/2023 |
| Last Update Date | 05/26/2023 |
| Certification Date | 05/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427749845 | NPI | - | NPPES |
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