Organization Name: | SULLIVAN COUNTY MEMORIAL HOSPITAL |
NPI Number: | 1285775858 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMY MICHAEL (CHIEF OPERATING OFFICER) |
Mailing Address: | 630 W 3rd St Milan |
State: | MO US |
Postal Code: | 635561076 |
Phone Number: | 6602654212 |
Fax Number: | 6602654898 |
NPI Enumeration Date: | 02/08/2007 |
NPI Last Update Date: | 07/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | 130-49 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |