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201 Bailey Lane Benton IL 62812-0000 | |
(618) 439-3161 | |
(618) 439-4049 |
Full Name | |
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Speciality | Clinic/Center |
Location | 201 Bailey Lane, Benton, Illinois |
Authorized Official Name and Position | Rikki Bonthron (CFO) |
Authorized Official Contact | 6184393161 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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201 Bailey Lane Benton IL 62812-0000 Ph: (618) 439-3161 | 201 Bailey Lane Benton IL 62812-0000 Ph: (618) 439-3161 |
NPI Number | 1033140488 |
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Provider Enumeration Date | 07/05/2006 |
Last Update Date | 02/25/2019 |
Medicare PECOS PAC ID | 4082516042 |
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Medicare Enrollment ID | O20050531000098 |
Identifier | Type | State | Issuer |
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1033140488 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | 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 | |