| Logan Primary Care Service | |
|
502 W St Louis West Frankfort IL 62896-1968 | |
| (618) 997-3400 | |
| (618) 932-3797 |
| Full Name | Logan Primary Care Service |
|---|---|
| Speciality | Clinic/Center |
| Location | 502 W St Louis, West Frankfort, Illinois |
| Authorized Official Name and Position | Rex P Budde (CEO/PRESIDENT) |
| Authorized Official Contact | 6184575200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Logan Primary Care Service 405 Rushing Dr Herrin IL 62948-3730 Ph: (618) 993-3300 | Logan Primary Care Service 502 W St Louis West Frankfort IL 62896-1968 Ph: (618) 997-3400 |
| NPI Number | 1215204938 |
|---|---|
| Provider Enumeration Date | 11/23/2011 |
| Last Update Date | 11/23/2011 |
| Medicare PECOS PAC ID | 3678677390 |
|---|---|
| Medicare Enrollment ID | O20120315000819 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215204938 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Illinois) | Primary |
Logan Primary Care Service Corp. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 W St Louis, West Frankfort, IL 62896 Phone: 618-997-3400 Fax: 618-932-3797 | |
West Frankfort Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2553 Ken Gray Blvd, West Frankfort, IL 62896 Phone: 618-932-3937 Fax: 618-932-3507 | |
Professional Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 W Saint Louis St, West Frankfort, IL 62896 Phone: 618-932-2200 Fax: 618-932-2202 | |
West Frankfort Family Healthcare Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 309 W Saint Louis St Ste B, West Frankfort, IL 62896 Phone: 618-932-2200 Fax: 618-932-2202 | |
West Frankfort Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 West St Louis Street, West Frankfort Community Health Center, West Frankfort, IL 62896 Phone: 618-937-6409 Fax: 618-937-1619 | |
Franklin Rural Health Clinic Iii Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 309 W Saint Louis St, West Frankfort, IL 62896 Phone: 618-937-3526 Fax: 618-932-3619 |