| Carbondale Care A Van | |
|
300 W Oak St Ste 100 Carbondale IL 62901-1496 | |
| (618) 453-3777 | |
| (618) 453-1102 |
| Full Name | Carbondale Care A Van |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 300 W Oak St Ste 100, Carbondale, Illinois |
| Authorized Official Name and Position | Iris Wesley (C.E.O.) |
| Authorized Official Contact | 2175458137 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carbondale Care A Van 201 E Madison St Ste 328 Springfield IL 62702-5131 Ph: (217) 545-6523 | Carbondale Care A Van 300 W Oak St Ste 100 Carbondale IL 62901-1496 Ph: (618) 453-3777 |
| NPI Number | 1215978127 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 05/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215978127 | NPI | - | NPPES |
| CE8688 | Other | IL | RR MEDICARE |
| CE8687 | Other | IL | RR MEDICARE |
| CE8689 | Other | IL | RR MEDICARE |
| CE8931 | Other | IL | RR MEDICARE |
| CB2589 | Other | IL | RR HEALTH |
| CE8686 | Other | IL | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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