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Contact Information

ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS
400 N PLEASANT AVE
CENTRALIA, IL62801-3056
 Phone: 618-436-8000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
 

Interventional Cardiology

207RI0011X 11 Physician/Internal Medicine
 

Neurology

2084N0400X 13 Physician/Neurology
 

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
 

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
 

Respiratory Therapist, Certified

227800000X
 

Respiratory Therapist, Registered

227900000X
Indicates primary specialty

NPI Profile & details for ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS

NPI # 1770687196
LBN Legal business name ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS
Authorized official DAMON HARBISON - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/08/2006
Last updated 11/27/2023 - About 3 years ago
Identifiers
IL License # 0002642
IL Other 6110182 BLUE CROSS BLUE SHIELD
IL Other 35110 GROUP HEALTH PLAN
IL Other 247625 HEALTHLINK NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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