| St. Mary's Hospital | |
|
205 Huron Irvington IL 62848 | |
| (618) 249-6203 | |
| Not Available |
| Full Name | St. Mary's Hospital |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 205 Huron, Irvington, Illinois |
| Authorized Official Name and Position | Bruce Merrell (PRESIDENT) |
| Authorized Official Contact | 6184366205 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Mary's Hospital Po Box 503861 Saint Louis MO 63150-0001 Ph: (618) 249-6203 | St. Mary's Hospital 205 Huron Irvington IL 62848 Ph: (618) 249-6203 |
| NPI Number | 1285630624 |
|---|---|
| Provider Enumeration Date | 06/21/2005 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285630624 | NPI | - | NPPES |
| 128375 | Other | IL | HEALTHLINK |
| 9515007 | Other | IL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 0002642 (Illinois) | Primary |
Irvington Friendly Care, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Huron, Irvington, IL 62848 Phone: 618-249-6203 Fax: 618-249-6263 |