# PERRY COUNTY MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Main Street Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740151489
- **Authorized official:** CRYSTAL LEE HINTON (PROVIDER ENROLLMENT)
- **Authorized official phone:** (812) 772-0589

## Contact information

- **Practice address:** 715 MAIN ST, TELL CITY, IN 47586-1705
- **Practice address phone:** (812) 548-4480
- **Practice address fax:** (812) 772-0560
- **Mailing address:** 715 MAIN ST, TELL CITY, IN 47586-1705
- **Mailing address phone:** (812) 548-4480
- **Mailing address fax:** (812) 772-0560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/16/2025
- **Last updated:** 05/05/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 300124476 | — | IN |
| 05 | — | 7101121230 | — | KY |