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General NPI Number Information
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NPI Number | 1124713763
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Entity Type | Organization
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Legal Business Name | PERRY COUNTY MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 109 US HIGHWAY 66 E
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City | TELL CITY
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State | IN
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Zip | 47586-2799
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Country | US
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Telephone | 812-547-3447
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27066
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City | BELFAST
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State | ME
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Zip | 04915-2022
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Country | US
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Telephone | 812-547-3447
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Fax |
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT
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Name | CRYSTAL LEE HINTON
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Credential |
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Telephone | 812-772-0589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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