| Gibson Community Hospital Association | |
|
1504 Patton Dr Ste 2 Mahomet IL 61853-8126 | |
| (217) 586-2633 | |
| (217) 590-0272 |
| Full Name | Gibson Community Hospital Association |
|---|---|
| Speciality | Clinic/Center |
| Location | 1504 Patton Dr Ste 2, Mahomet, Illinois |
| Authorized Official Name and Position | Matthew Ertel (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2177842601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gibson Community Hospital Association 1504 Patton Dr Ste 2 Mahomet IL 61853-8126 Ph: (217) 586-2633 | Gibson Community Hospital Association 1504 Patton Dr Ste 2 Mahomet IL 61853-8126 Ph: (217) 586-2633 |
| NPI Number | 1689198863 |
|---|---|
| Provider Enumeration Date | 07/31/2017 |
| Last Update Date | 02/04/2022 |
| Medicare PECOS PAC ID | 5092703124 |
|---|---|
| Medicare Enrollment ID | O20171006000117 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689198863 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |