| Memorial Physician Services | |
|
1 Centre Dr Petersburg IL 62675-9467 | |
| (217) 632-7761 | |
| (217) 632-0312 |
| Full Name | Memorial Physician Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 Centre Dr, Petersburg, Illinois |
| Authorized Official Name and Position | James T Dowell (VICE PRESIDENT, MPS) |
| Authorized Official Contact | 2177883342 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Physician Services Po Box 3428 Springfield IL 62708-3428 Ph: (800) 577-5368 | Memorial Physician Services 1 Centre Dr Petersburg IL 62675-9467 Ph: (217) 632-7761 |
| NPI Number | 1790038099 |
|---|---|
| Provider Enumeration Date | 10/24/2012 |
| Last Update Date | 02/11/2021 |
| Medicare PECOS PAC ID | 9032005681 |
|---|---|
| Medicare Enrollment ID | O20130116000579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790038099 | NPI | - | NPPES |
| 143936 | Other | RHC MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Menard Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Centre Dr, Petersburg, IL 62675 Phone: 217-632-7761 Fax: 217-632-0312 | |
Menard Medical Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Centre Dr, Petersburg, IL 62675 Phone: 217-632-7761 Fax: 217-632-0312 | |
Menard Medical Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Centre Dr, Petersburg, IL 62675 Phone: 217-632-7761 Fax: 217-632-0312 | |
Menard Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Centre Dr, Petersburg, IL 62675 Phone: 217-632-7761 Fax: 217-632-0312 |