SULLIVAN COUNTY MEMORIAL HOSPITAL NPI 1285775858

NPI Information

NPI: 1285775858
Provider Name: SULLIVAN COUNTY MEMORIAL HOSPITAL
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 26D0441684

Address:
630 W 3RD ST
MILAN, MO
ZIP 63556
Phone: (660) 265-4212
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SULLIVAN COUNTY MEMORIAL HOSPITAL is a rural health clinic center in Milan, MO. SULLIVAN COUNTY MEMORIAL HOSPITAL NPI is 1285775858. The provider is registered as an organization entity type.

The provider's business location address is:

630 W 3RD ST
MILAN, MO
ZIP 63556
Phone: (660) 265-4212
Fax: (660) 265-4898

The provider's authorized official is Amy Michael .
The authorized official title is Coo and has the following contact phone number (660) 265-4212.

The CLIA number assigned to this NPI record is 26D0441684 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/8/2007 and was last updated on 7/9/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health	130-49	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	599995107	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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