Harrisburg Medical Center Inc
Organization Active NPI Rural Health Clinic/Center · Eldorado, IL
NPI 1992773873 · NPPES record last updated Oct 15, 2012
Key facts
- NPI
- 1992773873
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- 0000521 (IL)
- Legal business name
- HARRISBURG MEDICAL CENTER INC
- Practice address
- 1007 US Route 45
Eldorado, IL 62930 - Phone
- (618) 273-7723
- Fax
- (618) 273-3384
- NPI assigned
- Mar 8, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- HARRISBURG MEDICAL CENTER INC
Authorized official
- Name
- Mr. Rodney D Smith
- Title
- President/Ceo
- Phone
- (618) 253-7671
Other NPIs on the same Medicare enrollment 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031113000179 | IL | Part B Supplier - Clinic/Group Practice | 9638083884 |
Receives reassigned benefits from 48 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Eldorado, IL; Harrisburg, IL; Marion, IL |
National Provider Directory
- Part of
- Harrisburg Medical CNTR Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | 0000521 | IL | Yes |
Addresses
Primary practice location
1007 US Route 45
Eldorado, IL 62930
Mailing address
PO Box 250
Eldorado, IL 62930-0250
Phone (618) 273-7723
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 143471 | Other | IL | HEALTHLINK |
| 8315011 | Other | IL | BLUE CROSS PROVIDER NUMBE |
| 817400 | Other | IL | WPS PROVIDER NUMBER |
Other names
- Eldorado Primary Care
Other providers in Eldorado, IL
- Sylvia Elaine Harrington
- Harrisburg Medical Center Inc
- Harrisburg Medical Center Inc
- Harrisburg Medical Center Inc
- Harrisburg Medical Center Inc
- Reid Harrison
- Ashley Hatton
- Rachel Haug
- Mark Lynn Hawkins II
- Dellenia Dale Hazel
All providers in Eldorado, IL · Rural Health Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.