Provider Demographics
NPI:1124905351
Name:FERRELL HOSPITAL COMMUNITY FOUNDATION
Entity type:Organization
Organization Name:FERRELL HOSPITAL COMMUNITY FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BOARD
Authorized Official - Prefix:
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-273-3361
Mailing Address - Street 1:1201 PINE ST
Mailing Address - Street 2:
Mailing Address - City:ELDORADO
Mailing Address - State:IL
Mailing Address - Zip Code:62930-1634
Mailing Address - Country:US
Mailing Address - Phone:618-273-3361
Mailing Address - Fax:618-273-2504
Practice Address - Street 1:HARRISBURG SMALL STREET CLINIC
Practice Address - Street 2:250 SMALL STREET
Practice Address - City:HARRISBURG
Practice Address - State:IL
Practice Address - Zip Code:62946-3319
Practice Address - Country:US
Practice Address - Phone:618-294-8264
Practice Address - Fax:618-294-8265
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FERRELL HOSPITAL COMMUNITY FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty