# SULLIVAN COUNTY MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518008218
- **Authorized official:** AMY MICHAEL (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (660) 265-4212

## Contact information

- **Practice address:** 18 W 3RD ST, GREEN CITY, MO 63545-1361
- **Practice address phone:** (660) 874-5887
- **Practice address fax:** (660) 874-5886
- **Mailing address:** 630 W 3RD ST, MILAN, MO 63556-1076
- **Mailing address phone:** (660) 265-4212
- **Mailing address fax:** (660) 265-4898

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 130-55 | MO | Yes |

## Other

- **Enumeration date:** 02/08/2007
- **Last updated:** 09/09/2013