Basic Information
| Provider Information | |||||||||
| NPI: | 1750308631 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNITY HOSPITAL OF STAUNTON | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 N CALDWELL ST | ||||||||
| Address2: | |||||||||
| City: | STAUNTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 620881423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6186352200 | ||||||||
| FaxNumber: | 6186354244 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 N CALDWELL ST | ||||||||
| Address2: | |||||||||
| City: | STAUNTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 620881423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6186352200 | ||||||||
| FaxNumber: | 6186354244 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2006 | ||||||||
| LastUpdateDate: | 02/24/2020 | ||||||||
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| AuthorizedOfficialLastName: | CAMPBELL | ||||||||
| AuthorizedOfficialFirstName: | SUE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6186354241 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| NPICertificationDate: | 02/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | 0000414 | IL | Y | Hospitals | General Acute Care Hospital | Critical Access |
No ID Information.