Memorial Home Services of Central Illinois, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MEMORIAL HOME SERVICES OF CENTRAL ILLINOIS, INC

Practice address

306 N Westgate Ave Ste a
Jacksonville, IL 62650-3713

Phone

(217) 788-4663

NPI assigned

Aug 12, 2014

Last updated

May 2, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

MEMORIAL HOME SERVICESAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Lori Valentine, RN

Title

Director, DME

Phone

(217) 788-4663

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Memorial Home Services

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Memorial Home Services

  • Community Based Hospice Care Agency
  • Springfield, IL
  • NPI 1003935560

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462147200000",
    "number": "1194134361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 N WESTGATE AVE STE A",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503713",
            "telephone_number": "217-788-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 N WESTGATE AVE STE A",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503713",
            "telephone_number": "217-788-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOME SERVICES OF CENTRAL ILLINOIS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HOME SERVICES",
        "enumeration_date": "2014-08-12",
        "last_updated": "2016-05-02",
        "status": "A",
        "authorized_official_last_name": "VALENTINE",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "DIRECTOR,  DME",
        "authorized_official_telephone_number": "217-788-4663",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "361190216013",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clayton Edward McDowell, DMD
• Monteria McGee
• Danica B McKain, APN
• Doug R McKain, DNP, FNP-C
• Allison Marie Meisner, M.D.
• Memorial Industrial Rehabilitation of Jacksonville
• Memorial Physician Services
• Memorial Physician Services
• Memorial Physician Services
• Memorial Physician Services

• Durable Medical Equipment & Medical Supplies in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.