Hardin County General Hospital Clinic

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

0000901 Issued in IL

Legal business name

HARDIN COUNTY GENERAL HOSPITAL CLINIC

Practice address

6 Ferrell Road
Rosiclare, IL 62982

Phone

(618) 285-2800

Fax

(618) 285-2804

NPI assigned

Oct 23, 2006

Last updated

Nov 25, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Roby D Williams

Title

Administrator

Phone

(618) 285-6634

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346323615. Details of each certification follow.

• CCN 143479 Rural health clinic · Active · Details

Rural health clinic certification: CCN 143479

Legal name

HARDIN COUNTY GENERAL HOSPITAL

Doing business as

HARDIN COUNTY GENERAL HOSPITAL AND CLINIC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Apr 4, 2006

Last certification

Apr 24, 2025

Ownership / control type

2B

Organization structure

CorporationNon-profit

Incorporated

Feb 11, 1953 in IL

Enrollment address

6 Ferrell Rd
Rosiclare, IL 62982-1052

Related CCNs

141328

Related certifications (CCN) 1

Facilities connected through Provider of Services related, parent or unit certification numbers.

• Hardin County General Hospital

  • Critical Access Hospital
  • Rosiclare, IL
  • NPI 1538165600

  Parent provider

  Provider of Services

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Hardin County General Hospital

  • Critical Access Hospital
  • Rosiclare, IL
  • NPI 1538165600

  O20060201000564

  Same enrollment

Tax ID family

Hardin County General Hospital Clinic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Hardin County General Hospital

  • Critical Access Hospital
  • Rosiclare, IL
  • NPI 1538165600
  NPD tax ID
• Hardin County General Hospital

  dba Hardin County General Hospital Ambulance

  • Land Ambulance
  • Rosiclare, IL
  • NPI 1679220149
  NPD tax ID
• Hardin County General Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Rosiclare, IL
  • NPI 1770666893
  NPD tax ID

Locations

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Marcos N Sunga Jr., MD

  • Internal Medicine Physician
  • Rosiclare, IL
  • NPI 1255331625

  Corporate Director, W-2 Managing Employee

  CMS ownership

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227571200000",
    "number": "1346323615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 FERRELL ROAD",
            "city": "ROSICLARE",
            "state": "IL",
            "postal_code": "62982",
            "telephone_number": "618-285-2800",
            "fax_number": "618-285-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 FERRELL ROAD",
            "city": "ROSICLARE",
            "state": "IL",
            "postal_code": "62982",
            "telephone_number": "618-285-2800",
            "fax_number": "618-285-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARDIN COUNTY GENERAL HOSPITAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-11-25",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ROBY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-285-6634",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IL",
            "license": "0000901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NO.",
            "identifier": "0247",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hardin County Ambulance Service
• Hardin County Discount Pharmacy, Inc.
• Hardin County General Hospital
• Hardin County General Hospital (Hardin County General Hospital Ambulance)
• Hardin County General Hospital
• Hardin County Pharmacy LLC
• Cheryl Hicks
• Angela Brooke Kaylor, NP
• Megan Leahy
• Petersen Health Network, LLC (Whispering Oaks)

• Rural Health Clinic/Center in Rosiclare, IL
• Providers in Rosiclare, IL by specialty
• Rural Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.