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Contact Information

COUNTY OF RANDOLPH NURSING HOME
312 W BELMONT ST
SPARTA, IL62286-1709
 Phone: 618-443-4351
 Fax: 618-443-2700
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for COUNTY OF RANDOLPH NURSING HOME

NPI # 1881734416
LBN Legal business name COUNTY OF RANDOLPH NURSING HOME
Authorized official LIZ DILDAY - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 02/06/2007
Last updated 08/19/2008 - About 18 years ago
Identifiers
IL License # 0000497
IL Medicaid 0000497
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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