# MONTICELLO MEDICAL CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NO
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1871645531
- **Legal business name:** NO
- **Authorized official:** DR. CHARLES R. TRIBBETT M.D. (OWNER)
- **Authorized official phone:** (574) 583-3333

## Contact information

- **Practice address:** 826 N 6TH ST, MONTICELLO, IN 47960-1752
- **Practice address phone:** (574) 583-3333
- **Practice address fax:** (574) 583-4785
- **Mailing address:** 826 N 6TH ST, MONTICELLO, IN 47960-1752
- **Mailing address phone:** (574) 583-3333
- **Mailing address fax:** (574) 583-4785

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | IN | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | IN | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/16/2007
- **Last updated:** 08/02/2011