| |
303 E Bidwell St Taylorville IL 62568-1363 | |
(217) 824-4939 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 303 E Bidwell St, Taylorville, Illinois |
Authorized Official Name and Position | Randy Bryant (ASSISTANT ADMINISTRATOR - CEO) |
Authorized Official Contact | 2175287541 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1025 S 6th St Springfield IL 62703-2403 Ph: (217) 528-7541 | 303 E Bidwell St Taylorville IL 62568-1363 Ph: (217) 824-4939 |
NPI Number | 1235316191 |
---|---|
Provider Enumeration Date | 01/23/2008 |
Last Update Date | 08/15/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235316191 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Toofan Medical Holdings, Ltd. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1510 W Springfield Rd Ste A, Taylorville, IL 62568 Phone: 217-824-8244 Fax: 217-994-9304 | |