# MOULTRIE CO

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

## Provider details

- **NPI number:** 1538213285
- **Authorized official:** MRS. ANGELA L. HOGAN RN MSPH (ADMINISTRATOR)
- **Authorized official phone:** (217) 728-4114

## Contact information

- **Practice address:** 202 S MAIN ST, SULLIVAN, IL 61951-1958
- **Practice address phone:** (217) 728-4114
- **Practice address fax:** (217) 728-2650
- **Mailing address:** 202 S MAIN ST, SULLIVAN, IL 61951-1958
- **Mailing address phone:** (217) 728-4114
- **Mailing address fax:** (217) 728-2650

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 01/22/2007
- **Last updated:** 12/08/2014