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General NPI Number Information
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NPI Number | 1154939320
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Entity Type | Organization
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Legal Business Name | SULLIVAN COUNTY COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 07/14/2020
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Provider Practice Location Address
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Address Line | 2200 N SECTION ST
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City | SULLIVAN
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State | IN
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Zip | 47882-7523
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Country | US
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Telephone | 812-268-3318
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10
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City | SULLIVAN
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State | IN
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Zip | 47882-0010
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Country | US
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Telephone | 812-268-4311
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF REVENUE CYCLE
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Name | DARRELL D WATSON
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Credential |
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Telephone | 812-268-4311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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