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905 W Washington St Ste A Benton IL 62812 | |
(618) 435-2229 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 905 W Washington St Ste A, Benton, Illinois |
Authorized Official Name and Position | Tara P Richardson (AUTHORIZED OFFICIAL) |
Authorized Official Contact | 6152213672 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 689022 Franklin TN 37068-9022 Ph: (800) 709-7338 | 905 W Washington St Ste A Benton IL 62812 Ph: (618) 435-2229 |
NPI Number | 1982955712 |
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Provider Enumeration Date | 09/19/2012 |
Last Update Date | 04/23/2019 |
Identifier | Type | State | Issuer |
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1982955712 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 0003947 (Illinois) | Primary |
Christopher Greater Area Rural Health Planning Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 206 E Church St, Benton, IL 62812 Phone: 618-435-9888 Fax: 618-435-9889 | |
Christopher Greater Area Rural Health Planning Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 107 E Smith St Ste B, Benton, IL 62812 Phone: 618-435-9315 Fax: 618-435-9316 | |