Active NPI
Gholson Funeral Home LTD
- Land Ambulance
- McLeansboro, IL
National Provider Identifier
1639241979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 5172
- Legal business name
- GHOLSON FUNERAL HOME LTD
- Practice address
- 500 S Washington St
MC Leansboro, IL 62859-1238 - Phone
- (618) 643-2321
- Fax
- (618) 643-2322
- NPI assigned
- Nov 14, 2006
- Last updated
- Feb 21, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- J.B. Gholson
- Title
- Director
- Phone
- (618) 643-2321
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 5172 | IL | Primary |
Addresses
Primary practice location
500 S Washington St
MC Leansboro, IL 62859-1238
Mailing address
500 S Washington St
MC Leansboro, IL 62859-1238
Phone (618) 643-2321
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0008470065 | Other | IL | BLUE CROSS BLUE SHIELD IL |
| 590155125 | Other | IL | RAILROAD MEDICARE |
National Provider Directory
National Provider DirectoryLocations
500 S Washington St
Mc Leansboro, IL 62859
Phone (618) 643-2321
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1329782400000",
"number": "1639241979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 S WASHINGTON ST",
"city": "MC LEANSBORO",
"state": "IL",
"postal_code": "628591238",
"telephone_number": "618-643-2321",
"fax_number": "618-643-2322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S WASHINGTON ST",
"city": "MC LEANSBORO",
"state": "IL",
"postal_code": "628591238",
"telephone_number": "618-643-2321",
"fax_number": "618-643-2322"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GHOLSON FUNERAL HOME LTD",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-14",
"last_updated": "2012-02-21",
"status": "A",
"authorized_official_last_name": "GHOLSON",
"authorized_official_first_name": "J.B.",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "618-643-2321"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "IL",
"license": "5172",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD IL",
"identifier": "0008470065",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "590155125",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in McLeansboro, IL
- Family Medicine of McLeansboro LLC
- Ferrell Hospital Community Foundation (McLeansboro Family Medicine)
- Ferrell Hospital Community Foundation
- Fox Meadows SLF LP (Heritage Woods of McLeansboro)
- Freds Stores of Tennessee Inc (Freds Pharmacy 2349)
- Grace Healthcare Services, LLC
- Brian D. Haeuber, D.M.D
- Hamilton Co Cu School Dist 10
- Hamilton County Ambulance Service
- Hamilton County Cusd No 10
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.