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203 W Front St Annawan IL 61234-7756 | |
(309) 935-4100 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 203 W Front St, Annawan, Illinois |
Authorized Official Name and Position | Rhonda Rice (REVENUE CYCLE MANAGER) |
Authorized Official Contact | 3099449122 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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600 N College Ave Geneseo IL 61254-1091 Ph: (309) 944-6431 | 203 W Front St Annawan IL 61234-7756 Ph: (309) 935-4100 |
NPI Number | 1114582913 |
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Provider Enumeration Date | 05/07/2019 |
Last Update Date | 09/30/2020 |
Medicare PECOS PAC ID | 0143115949 |
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Medicare Enrollment ID | O20190919000007 |
Identifier | Type | State | Issuer |
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1114582913 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |