Public record

CMS Federally Qualified Health Center All Owners

Associate id - owner: 4688579873 · 37 matching records

Enrollment id: O20060208000832
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CEO

Enrollment id: O20071227000556
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CHIEF EXECUTIVE OFFICER

Enrollment id: O20081029000867
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CEO

Enrollment id: O20081029000897
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CEO

Enrollment id: O20081029000941
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2011-02-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20081029000945
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 41
Role text - owner: CORPORATE DIRECTOR
Association date - owner: 1997-03-17
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CHIEF EXECUTIVE OFFICER
Percentage ownership: 0

Enrollment id: O20081029000949
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20081030000237
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CHEIF EXECUTIVE OFFICER

Enrollment id: O20081030000255
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CEO

Enrollment id: O20090326000134
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 41
Role text - owner: CORPORATE DIRECTOR
Association date - owner: 1997-03-17
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20090708000671
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CEO

Enrollment id: O20090716000602
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CEO

Enrollment id: O20100311000882
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20110311000451
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 41
Role text - owner: CORPORATE DIRECTOR
Association date - owner: 1997-03-17
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20110420000436
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 41
Role text - owner: CORPORATE DIRECTOR
Association date - owner: 1997-03-17
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20120220000066
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20120806000072
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: BOARD MEMBER / CEO
Percentage ownership: 0

Enrollment id: O20121120000102
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CHIEF EXECUTIVE OFFICER

Enrollment id: O20130308000481
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CHIEF EXECUTIVE OFFICER

Enrollment id: O20140422000002
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 41
Role text - owner: CORPORATE DIRECTOR
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CHIEF EXECUTIVE OFFICER
Percentage ownership: 0

Enrollment id: O20140820001464
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2010-04-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CEO

Enrollment id: O20160420001731
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2011-02-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CHIEF EXECUTIVE OFFICER

Enrollment id: O20161018001776
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2011-02-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CHIEF EXECUTIVE OFFICER
Percentage ownership: 0

Enrollment id: O20170425000282
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2011-02-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CEO

Enrollment id: O20170913000810
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2011-02-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CHIEF EXECUTIVE OFFICER
Percentage ownership: 0

Enrollment id: O20171026001503
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2011-02-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: BOARD MEMBER
Percentage ownership: 0

Enrollment id: O20171026001706
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2011-02-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20230206001728
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2004-02-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20240322002923
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2004-02-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20240410001472
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2004-02-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20240416002738
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2004-02-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20240805000037
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2004-02-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20240925002886
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2004-02-01
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20241207000017
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 2024-12-16
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY
Title - owner: CEO

Enrollment id: O20260612000103
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 1997-03-17
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20260625003129
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 1997-03-17
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

Enrollment id: O20260903000253
Associate id: 1456256874
Organization name: SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC
Associate id - owner: 4688579873
Type - owner: I
Role code - owner: 40
Role text - owner: CORPORATE OFFICER
Association date - owner: 1997-03-17
First name - owner: LARRY
Middle name - owner: W
Last name - owner: MCCULLEY

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