MEMORIAL HOSPITAL ASSOCIATION (NPI# 1437100831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437100831 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL ASSOCIATION |
| Other Organization Name | BOWEN FAMILY CLINIC |
| Practice Address |
209 E 5th Street Bowen IL 62316 |
| Mailing Address |
Po Box 105 Bowen IL 62316-0105 |
| Practice Telephone | 2178425211 |
| Practice Fax Number | 2178425202 |
| Mailing Telephone | 2178425211 |
| Mailing Fax Number | 2178425202 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2019-04-05 |
| Authorized Official Name | ADA M BAIR (CEO) |
| Authorized Official Telephone | 2173578566 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEMORIAL HOSPITAL ASSOCIATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
0001529 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE SHIELD | 3420307 | 01 |
| Other Name | Type Code |
|---|---|
| Bowen Family Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225305444 | Memorial Hospital Association | Public Health or Welfare | 206 N Broadway Ave, Red Lodge, MT 59068-9369 | 2011-11-17 |
| 1891972451 | Memorial Hospital Association | Clinic/Center | 1370 Mulholland St, Nauvoo, IL 62354-1010 | 2008-01-25 |
| 1659433175 | Memorial Hospital Association | General Acute Care Hospital | 600 W 21st Street, Red Lodge, MT 59068-0590 | 2006-12-14 |
| 1144381054 | Memorial Hospital Association | General Acute Care Hospital | 600 West 21st Street, Red Lodge, MT 59068-0590 | 2006-12-13 |
| 1942378534 | Memorial Hospital Association | Skilled Nursing Facility | 600 West 21st St, Red Lodge, MT 59068-0590 | 2006-12-01 |
| 1205887742 | Memorial Hospital Association | Clinic/Center | 403 S Adams St, Suite 239, Carthage, IL 62321-1624 | 2006-05-12 |
| 1588614002 | Memorial Hospital Association | Clinic/Center | 1450 N County Rd 2050, Carthage, IL 62321-0160 | 2006-05-12 |
| 1730139031 | Memorial Hospital Association | General Acute Care Hospital | 1454 N County Road 2050, Carthage, IL 62321-3551 | 2006-05-10 |
| 1336119338 | Memorial Hospital Association | General Acute Care Hospital | 2525 North Broadway, Red Lodge, MT 59068-0590 | 2006-01-24 |
| 1699228882 | Memorial Hospital Association | Clinic/Center | 110 E Market St, Colchester, IL 62326-1271 | 2016-07-25 |
| Street Address |
209 E 5TH STREET |
| City | BOWEN |
| State | IL |
| Zip Code | 62316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508831520 | Jeffrey A Leon | Family Medicine | 209 E 5th St, Bowen, IL 62316 | 2006-02-22 |
| 1942403134 | Southeastern Cu Sch Dist 337 | Local Education Agency (LEA) | Highway 94 North, Bowen, IL 62316-0247 | 2007-06-06 |
| 1730606443 | Kayla Neisen | Psychologist | 607 N Worrell St, Bowen, IL 62316-1048 | 2017-08-23 |
| 1437677390 | Caitlyn Jo Fink | Speech-Language Pathologist | 607 N Worrell St, Bowen, IL 62316-1048 | 2017-08-31 |
| 1609363266 | Phyllis R Wear | Nurse Practitioner | 209 E 5th St, Bowen, IL 62316-1130 | 2018-04-19 |
| 1093335739 | Romel Tournear | Physical Therapy Assistant | 208 W 4th St, Bowen, IL 62316-1152 | 2020-04-22 |
| 1043571227 | Catherine Ann Bruening | Developmental Therapist | 2040 E County Road 50, Bowen, IL 62316-2208 | 2012-06-04 |
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.