Healthcare Provider Details

I. General information

NPI: 1023009339
Provider Name (Legal Business Name): PERRY COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 US HIGHWAY 66 E
TELL CITY IN
47586-2755
US

IV. Provider business mailing address

8885 STATE ROAD 237
TELL CITY IN
47586-8567
US

V. Phone/Fax

Practice location:
  • Phone: 812-547-3447
  • Fax: 812-547-9543
Mailing address:
  • Phone: 812-547-7011
  • Fax: 812-547-0174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number158516
License Number StateIN

VIII. Authorized Official

Name: JARED STIMPSON
Title or Position: CEO
Credential:
Phone: 812-547-0170