| Shawnee Health Service And Development Corp | |
|
101 S Wall St Carbondale IL 62901-3021 | |
| (618) 519-9200 | |
| (618) 519-9404 |
| Full Name | Shawnee Health Service And Development Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 101 S Wall St, Carbondale, Illinois |
| Authorized Official Name and Position | Christina Carney (CEO) |
| Authorized Official Contact | 6189569521 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shawnee Health Service And Development Corp 109 California St P O Box 577 Carterville IL 62918-0577 Ph: (618) 985-8221 | Shawnee Health Service And Development Corp 101 S Wall St Carbondale IL 62901-3021 Ph: (618) 519-9200 |
| NPI Number | 1457381774 |
|---|---|
| Provider Enumeration Date | 07/03/2006 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/29/2024 |
| Medicare PECOS PAC ID | 1658285671 |
|---|---|
| Medicare Enrollment ID | O20050531000530 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457381774 | NPI | - | NPPES |
| 10032052 | Other | IL | BCBS |
| CF3444 | Other | IL | MEDICARE RAILROAD |
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