Jerseyville Pain Management Center, S.C.
Organization Active NPI Non-Pharmacy Dispensing Site · Wood River, IL
NPI 1255609574 · NPPES record last updated Jan 3, 2012
Key facts
- NPI
- 1255609574
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Non-Pharmacy Dispensing Site 332900000X
- Legal business name
- JERSEYVILLE PAIN MANAGEMENT CENTER, S.C.
- Practice address
- 1702 Vaughn Rd
Wood River, IL 62095-1898 - Phone
- (618) 259-3321
- NPI assigned
- Dec 1, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- JERSEYVILLE PAIN MANAGEMENT CENTER, S.C.
Authorized official
- Name
- Dr. Bud Chomhirun, M.D.
- Title
- Medical Director
- Phone
- (618) 259-3321
Corporate family (same tax ID) 1
Practitioners 2
-
James A Briggs, DC
-
Todd Edward Meiser, LPT
National Provider Directory
- Tax ID family
- Jerseyville Pain Management
- Part of
- Jerseyville Pain Management
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-Pharmacy Dispensing Site | 332900000X | Yes |
Addresses
Primary practice location
1702 Vaughn Rd
Wood River, IL 62095-1898
Mailing address
2980 N Beverly Glen Cir
Suite 301
Los Angeles, CA 90077-1726
Phone (310) 474-9809
Other providers in Wood River, IL
- Christopher Hurtte
- Tiffany Iberg
- In Situ Counseling & Coaching LLC
- Denise Marie Jacquin
- Jerseyville Pain Management Center, S.C.
- Jerseyville Pain Management Center, S.C.
- JKH Management, LLC
- Johnson'S Auditory Sales & Service, Inc.
- Johnson'S Auditory Sales & Service, Inc.
- Brandon Christopher Kopp
All providers in Wood River, IL · Non-Pharmacy Dispensing Site in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.