ST. LOUIS JC VAMC (NPI# 1497012652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497012652 |
| Entity Type | Organization |
| Organization Name | ST. LOUIS JC VAMC |
| Other Organization Name | HARRISBURG VA CBOC |
| Practice Address |
608 Rollie Moore Drive Harrisburg IL 62946-9998 |
| Mailing Address |
Po Box 94462 Cleveland OH 44101-4462 |
| Practice Telephone | 9135784409 |
| Mailing Telephone | 9135784409 |
| Mailing Fax Number | 9135784536 |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2018-01-17 |
| Authorized Official Name | ERIN POTTER (NPI TEAM MEMBER) |
| Authorized Official Telephone | 2023822579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QV0200X |
Clinic/Center Specialization: VA |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Harrisburg VA CBOC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114317369 | St. Louis Jc Vamc | Clinic/Center | 2600 Washington Boulevard, St. Louis, MO 63103-1420 | 2015-01-27 |
| 1396135513 | St. Louis Jc Vamc | Clinic/Center | 3615 Olive Street, St. Louis, MO 63108-3604 | 2015-01-26 |
| 1558751776 | St. Louis Jc Vamc | Clinic/Center | 3403 Heartland Street, Marion, IL 62959-6393 | 2015-01-26 |
| 1992067995 | St. Louis Jc Vamc | Clinic/Center | 1130 E Walnut St, Suite 100, Carbondale, IL 62901-5007 | 2012-06-14 |
| 1902198922 | St. Louis Jc Vamc | Clinic/Center | 1627 A Roy Dr, Washington, MO 63090-5008 | 2011-05-10 |
| 1619116399 | St. Louis Jc Vamc | Clinic/Center | 1253 Paris Rd, Suite A, Mayfield, KY 42066-4989 | 2009-02-19 |
| 1518155878 | St. Louis Jc Vamc | Clinic/Center | 6854 Parker Rd, Florissant, MO 63033-5313 | 2007-10-11 |
| 1578616892 | St. Louis Jc Vamc | Clinic/Center | 99 Stagecoach Rd, Madisonville, KY 42431-8009 | 2007-01-19 |
| 1902840622 | St. Louis Jc Vamc | Clinic/Center | 4105 N Water Tower Pl, Mount Vernon, IL 62864-6296 | 2006-06-15 |
| 1508809948 | St. Louis Jc Vamc | Clinic/Center | 2420 Linwood Dr, Suite 3, Paragould, AR 72450-6122 | 2006-06-14 |
| Street Address |
608 ROLLIE MOORE DRIVE |
| City | HARRISBURG |
| State | IL |
| Zip Code | 62946-9998 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770195117 | Leslie Wheeler | Pharmacist | #4 Commercial Drive, Harrisburg, IL 62946 | 2020-08-18 |
| 1215337266 | Prn Pharmacies Ltd | Durable Medical Equipment & Medical Supplies | 501 E. Sloan St., Harrisburg, IL 62946 | 2014-08-27 |
| 1316293855 | Steward Chiropractic Center, LLC | Chiropractor | 608 Rollie Moore Dr., Suite 2, Harrisburg, IL 62946 | 2012-08-02 |
| 1558664664 | Harrisburg Medical Center Inc | Clinic/Center | 183 W Lane St, Equality, IL 62946 | 2010-12-10 |
| 1588849178 | Scarlett Annette Oyler | Technician, Other | 607 W Commercial Suite, Harrisburg, IL 62946 | 2008-01-02 |
| 1043427958 | Debbie Oglesby | Case Manager/Care Coordinator | #22 Veterans Drive, Harrisburg, IL 62946 | 2007-05-17 |
| 1336272764 | Coleman Tri-county Services, Inc. | Community/Behavioral Health | # 22 Veterans Drive, Harrisburg, IL 62946 | 2007-03-14 |
| 1437212081 | Harris Frank LLC | Skilled Nursing Facility | Harrisburg Care Center, 1000 West Sloan St, Harrisburg, IL 62946 | 2006-12-18 |
| 1932269701 | Leanne H Deneal | Physician Assistant | 28 Veteran's Drive, Harrisburg, IL 62946 | 2006-12-11 |
| 1881646990 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 20 Veterans Drive, Harrisburg, IL 62946 | 2006-05-17 |
| Find all providers in zip 62946 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609426709 | Danville Vamc | Clinic/Center | 207 E Hamilton Rd, Bloomington, IL 61704-7527 | 2019-09-19 |
| 1437636966 | Miracle Healthcare LLC | Clinic/Center | 2024 Hickory Rd Ste 306, Homewood, IL 60430 | 2018-07-26 |
| 1558751776 | St. Louis Jc Vamc | Clinic/Center | 3403 Heartland Street, Marion, IL 62959-6393 | 2015-01-26 |
| 1669860458 | Chicago Vamc | Clinic/Center | 1141 South California Avenue, Chicago, IL 60608-9998 | 2014-12-31 |
| 1992067995 | St. Louis Jc Vamc | Clinic/Center | 1130 E Walnut St, Suite 100, Carbondale, IL 62901-5007 | 2012-06-14 |
| 1851660724 | Omaha Vamc | Clinic/Center | 406 Avenue C, Sterling, IL 61081-3407 | 2011-12-22 |
| 1902840622 | St. Louis Jc Vamc | Clinic/Center | 4105 N Water Tower Pl, Mount Vernon, IL 62864-6296 | 2006-06-15 |
| 1629016845 | Omaha Vamc | Clinic/Center | 6020 Broadway St, Quincy, IL 62305-7919 | 2006-06-02 |
| 1902843360 | Oak Park Va Clinic | Clinic/Center | 149 S Oak Park Ave, Oak Park, IL 60302-2901 | 2006-06-02 |
| 1154368710 | Hines Vamc | Clinic/Center | 10201 S Cicero Ave, Oak Lawn, IL 60453-4023 | 2006-06-01 |
| Find all providers with the same taxonomy | ||||
| City | HARRISBURG |
| Zip Code | 62946 |
Please comment or provide details below to improve the information on ST. LOUIS JC VAMC.
| 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.