Healthcare Provider Details

I. General information

NPI: 1154326098
Provider Name (Legal Business Name): PERRY COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 US HIGHWAY 66 E
TELL CITY IN
47586
US

IV. Provider business mailing address

8885 SR 237
TELL CITY IN
47586-2750
US

V. Phone/Fax

Practice location:
  • Phone: 812-547-7011
  • Fax: 812-547-0229
Mailing address:
  • Phone: 812-547-7011
  • Fax: 812-547-0174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number005344
License Number StateIN

VIII. Authorized Official

Name: RYAN WHITE
Title or Position: VP FINANCE/CFO
Credential:
Phone: 812-547-0146