ST. LOUIS JC VAMC


Address: 608 Rollie Moore Drive, Harrisburg, IL 62946-9998
Phone: 9135784409

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QV0200X Clinic/Center
Specialization: VA
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Harrisburg VA CBOC Other Name - Individual/Organization

Other Provider IDs and Locations

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

Office Location

Street Address 608 ROLLIE MOORE DRIVE
City HARRISBURG
State IL
Zip Code 62946-9998

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QV0200X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization VA

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

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
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Competitor

Search similar providers

City HARRISBURG
Zip Code 62946

Improve Information

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Dataset Information

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.

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