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GRAHAM HOSPITAL ASSOCIATION

Suppliers Pharmacy Long Term Care Pharmacy

Provider NPI: 1376659029

Organization Information:
Organization Name:  GRAHAM HOSPITAL ASSOCIATION
Organization is not Subpart
Authorized Official:  JULIE  REEDER  VP OF FINANCE/CFO  309-647-5240

Practice Location:
210 W WALNUT ST  CANTON, IL 61520-2444 US
Tel: 309-647-5240  Fax: 309-649-5110

Business Mailing Address:
210 W WALNUT ST  CANTON, IL 61520-2444 US
Tel: 309-647-5240  Fax: 309-649-5110

NPI Information:
NPI: 1376659029
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N3336L0003XSuppliers
Pharmacy
Long Term Care Pharmacy
Y3336I0012XSuppliers
Pharmacy
IL059.003399

Other Provider Identifiers:

IssuerNumberStateType
NABP NUMBER1433258IL01



American Medical Association 2012 taxonomy code information

Code: 3336I0012X

Type:

Classification:



Definition:



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