| Ssm Health Good Samaritan Hospital - Mt. Vernon | |
|
1 Good Samaritan Way Mount Vernon IL 62864-2402 | |
| (618) 899-4600 | |
| Not Available |
| Full Name | Ssm Health Good Samaritan Hospital - Mt. Vernon |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 1 Good Samaritan Way, Mount Vernon, Illinois |
| Authorized Official Name and Position | Jeremy Bradford (PRESIDENT) |
| Authorized Official Contact | 6188991001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ssm Health Good Samaritan Hospital - Mt. Vernon Po Box 503927 Saint Louis MO 63150-0001 Ph: (618) 899-4600 | Ssm Health Good Samaritan Hospital - Mt. Vernon 1 Good Samaritan Way Mount Vernon IL 62864-2402 Ph: (618) 899-4600 |
| NPI Number | 1609897339 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 11/27/2023 |
| Medicare PECOS PAC ID | 1658272059 |
|---|---|
| Medicare Enrollment ID | O20060320000309 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609897339 | NPI | - | NPPES |
| 140112100 | Other | IL | ACS OWCP NUMBER |
| 33898 | Other | IL | GROUP HEALTH PLAN NUMBER |
| 39584100 | Other | IL | BLACK LUNG NUMBER |
| 103233 | Other | IL | HEALTHLINK NUMBER |
| 003891 | Other | IL | HEALTH ALLIANCE NUMBER |
| 0014 | Other | IL | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 0004705 (Illinois) | Secondary |
| 282N00000X | General Acute Care Hospital | 0004705 (Illinois) | Primary |
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