Provider Demographics
NPI:1538229257
Name:TOUCHETTE REGIONAL HOSPITAL, INC.
Entity type:Organization
Organization Name:TOUCHETTE REGIONAL HOSPITAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMANUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-332-3060
Mailing Address - Street 1:129 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST SAINT LOUIS
Mailing Address - State:IL
Mailing Address - Zip Code:62201-2917
Mailing Address - Country:US
Mailing Address - Phone:618-482-7147
Mailing Address - Fax:618-482-7064
Practice Address - Street 1:129 N 8TH ST
Practice Address - Street 2:
Practice Address - City:EAST SAINT LOUIS
Practice Address - State:IL
Practice Address - Zip Code:62201-2917
Practice Address - Country:US
Practice Address - Phone:618-482-7147
Practice Address - Fax:618-482-7064
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOUCHETTE REGIONAL HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-11
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011015251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL352339OtherGROUP HEALTH PLAN
IL50920OtherBLUE CROSS OF ILLINOIS
ILN271026OtherHARMONY HEALTH PLAN
IL50920OtherBLUE CROSS OF ILLINOIS
ILN271026OtherHARMONY HEALTH PLAN