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General NPI Number Information
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NPI Number | 1245360213
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Entity Type | Organization
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Legal Business Name | PERRY COUNTY HEALTH SYSTEM
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 201 N. KINGSHIGHWAY
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City | PERRYVILLE
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State | MO
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Zip | 63775
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Country | US
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Telephone | 573-768-3210
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Fax |
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Provider Business Mailing Address
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Address Line | 434 N WEST ST
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City | PERRYVILLE
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State | MO
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Zip | 63775-1359
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Country | US
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Telephone | 573-547-2530
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MICHAEL ELLIS
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Credential |
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Telephone | 573-547-2536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 442-8
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License Number State | MO
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