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ALTON MEMORIAL HOSPITAL
NPI 1063669117
Ambulance in Alton, IL

Active since August 20, 2008CLIA Certified · 4 labs
1 MEMORIAL DR, ALTON, IL 62002(618) 463-7311(314) 653-4153 Get Directions Write a Review

NPPES record last updated: March 22, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Alton Memorial Hospital NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALTON MEMORIAL HOSPITAL (NPI 1063669117) is a healthcare organization registered as an ambulance in Alton, Illinois and active in the NPI registry since August 2008. The organization holds 4 active CLIA laboratory certificates and lists Susan Koesterer, Vice President, Finance, as its authorized official.

NPPES Registry Identity

NPI1063669117
Entity TypeOrganization
Primary Taxonomy341600000X
Legal Business NameALTON MEMORIAL HOSPITAL
Location Address1 MEMORIAL DRAlton, IL 62002-6722
Mailing Address1 Memorial DrAlton, IL 62002-6722 · (618) 463-7311 · Fax (314) 653-4153
Phone(618) 463-7311
Fax(314) 653-4153
Organization SubpartYes
Authorized OfficialSusan KoestererVice President, Finance · (314) 653-5715
Enumeration DateAugust 20, 2008
Last NPPES UpdateMarch 22, 2021
NPPES CertifiedMarch 22, 2021
✔ NPI 1063669117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAmbulanceTransportation Services
Taxonomy Code341600000X
License✔ Licensed in IL · 1706379
Definition
An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane).
1 MEMORIAL DR, Alton, IL 62002
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CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0900414

Alton Memorial Hospital · Alton, IL
Active · expires Apr 25, 2027
CLIA Number14D0900414
Laboratory TypeMobile Outreach Van
Certificate Effective DateApril 26, 2025
Certificate Expiration DateApril 25, 2027
Laboratory DirectorAngela M. Holbrook
Laboratory Phone(618) 463-7523
Laboratory LocationAlton Memorial Hospital1 Memorial Dr, Alton, IL 62002
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 14D2106562

Alton Memorial Hospital · Alton, IL
Active · expires Dec 20, 2027
CLIA Number14D2106562
Laboratory TypeHospital
Certificate Effective DateDecember 21, 2025
Certificate Expiration DateDecember 20, 2027
Laboratory DirectorAndrew C. Chu M D
Laboratory Phone(618) 463-7440
Laboratory LocationAlton Memorial HospitalOne Memorial Dr, Alton, IL 62002
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 14D1100272

Alton Memorial Hospital Ambulance · Alton, IL
Active · expires Jun 2, 2027
CLIA Number14D1100272
Laboratory TypeAmbulance
Certificate Effective DateJune 3, 2025
Certificate Expiration DateJune 2, 2027
Laboratory DirectorAlexander Zozula
Laboratory Phone(618) 463-7510
Laboratory LocationAlton Memorial Hospital AmbulanceOne Memorial Dr, Alton, IL 62002
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 14D0044509

Alton Memorial Hospital · Alton, IL
Active · expires Feb 27, 2027
CLIA Number14D0044509
Laboratory TypeHospital
Certificate Effective DateFebruary 28, 2025
Certificate Expiration DateFebruary 27, 2027
Laboratory DirectorDr. Andrew Chu
Laboratory Phone(618) 463-7400
Laboratory LocationAlton Memorial HospitalOne Memorial Dr, Alton, IL 62002
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIA M MILAZZO CRNA
Nurse Anesthetist, Certified Registered
1 MEMORIAL DR
ALTON, IL 62002
Madison County (618) 463-7311
DR. JULETTA AVAGYAN M.D.
Hospitalist
1 MEMORIAL DR
ALTON, IL 62002
Madison County (618) 463-7240
RODGER HANKO M.D.
Emergency Medicine
1 MEMORIAL DR
ALTON, IL 62002
Madison County (618) 463-7311
MATTHEW E DUBAN M.D., FACEP
Emergency Medicine
1 MEMORIAL DR
ALTON, IL 62002
Madison County (618) 463-7311
MS. SYLVIA G HOORMANN CRNA
Nurse Anesthetist, Certified Registered
1 MEMORIAL DR
ALTON, IL 62002
Madison County (618) 463-7311
MS. MEREDITH ANNE PARKER MSW, LCSW
Social Worker (Clinical)
1 MEMORIAL DR, 2ND FLOOR, OLIN WING
ALTON, IL 62002
Madison County (618) 463-7523
HOME CARE PHARMACY REFILL CTR
Pharmacy (Mail Order Pharmacy)
1 MEMORIAL DR
ALTON, IL 62002
Madison County (618) 463-7833
ALEXANDER BENJAMIN ZOZULA MD
Emergency Medicine
1 MEMORIAL DR
ALTON, IL 62002
Madison County (618) 463-7474

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alton Memorial Hospital's NPI number?

The NPI number for Alton Memorial Hospital is 1063669117. It was assigned to this organization in the NPPES registry on August 20, 2008.

Where is Alton Memorial Hospital located?

Alton Memorial Hospital is located at 1 Memorial Dr, Alton, IL 62002. The listed phone number is (618) 463-7311.

What is Alton Memorial Hospital's specialty?

The primary specialty registered for this NPI is Ambulance with taxonomy code 341600000X.

Does Alton Memorial Hospital hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Alton Memorial Hospital was last updated on March 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.