Cave In Rock Clinic | |
Canal Street Cave In Rock IL 62919 | |
(618) 289-4602 | |
(618) 289-4603 |
Full Name | Cave In Rock Clinic |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | Canal Street, Cave In Rock, Illinois |
Authorized Official Name and Position | Frederick Bernstein (CEO) |
Authorized Official Contact | 6184570450 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Cave In Rock Clinic Po Box 3008 Carbondale IL 62902-3008 Ph: (618) 457-0450 | Cave In Rock Clinic Canal Street Cave In Rock IL 62919 Ph: (618) 289-4602 |
NPI Number | 1104818665 |
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Provider Enumeration Date | 08/19/2005 |
Last Update Date | 08/30/2010 |
Identifier | Type | State | Issuer |
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1104818665 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |