| Ssm Health St. Mary's Hospital - Centralia | |
|
400 N Pleasant Ave Centralia IL 62801 | |
| (618) 436-8000 | |
| Not Available |
| Full Name | Ssm Health St. Mary's Hospital - Centralia |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 400 N Pleasant Ave, Centralia, Illinois |
| Authorized Official Name and Position | Damon R Harbison (PRESIDENT) |
| Authorized Official Contact | 6184368000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ssm Health St. Mary's Hospital - Centralia 1195 Corporate Lake Dr Saint Louis MO 63132-1716 Ph: (314) 989-3524 | Ssm Health St. Mary's Hospital - Centralia 400 N Pleasant Ave Centralia IL 62801 Ph: (618) 436-8000 |
| NPI Number | 1083617245 |
|---|---|
| Provider Enumeration Date | 05/23/2005 |
| Last Update Date | 11/27/2023 |
| Medicare PECOS PAC ID | 6709788920 |
|---|---|
| Medicare Enrollment ID | O20071110000096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083617245 | NPI | - | NPPES |
| 133046300 | Other | IL | ACS OWCP |
| 105814 | Other | IL | HEALTHLINK |
| 003578 | Other | IL | HEALTH ALLIANCE |
| 30045800 | Other | IL | BLACK LUNG |
| 35110 | Other | IL | GROUP HEALTH PLAN |
| 0182 | Other | IL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 0002642 (Illinois) | Secondary |
| 282N00000X | General Acute Care Hospital | 0002642 (Illinois) | Primary |
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Ssm Health St. Mary's Hospital - Centralia Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 400 N Pleasant Ave, Centralia, IL 62801 Phone: 618-436-8000 | |
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