PHYSICAL MEDICINE CLINIC OF GRANITE CITY LTD - NPI 1083986541 - Non-Pharmacy Dispensing Site in Granite City, IL

Q: What is Physical Medicine Clinic Of Granite City Ltd's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

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About Physical Medicine Clinic Of Granite City Ltd NPPES

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

PHYSICAL MEDICINE CLINIC OF GRANITE CITY LTD (NPI 1083986541) is a healthcare organization registered as a non-pharmacy dispensing site in Granite City, Illinois and active in the NPI registry since January 2012. The organization lists Bud Chombirun, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1083986541

Entity TypeOrganization

Primary Taxonomy332900000X

Legal Business NamePHYSICAL MEDICINE CLINIC OF GRANITE CITY LTD

Location Address2861 MADISON AVEGranite City, IL 62040-3614

Mailing Address2980 N Beverly Glen Cir, Suite 301Los Angeles, CA 90077-1726 · (310) 474-9809

Phone(618) 877-4000

Organization SubpartYes

Authorized OfficialBud ChombirunMedical Director · (618) 877-4000

Enumeration DateJanuary 31, 2012

✔ NPI 1083986541 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers

Taxonomy Code332900000X

Definition

A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

2861 MADISON AVE, Granite City, IL 62040

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Other Providers at the Same Location NPPES 9

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

JOSHUA H. HOTTES S.C.

Chiropractor