Organization
SULLIVAN COUNTY MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY MICHAEL (CHIEF FINANCIAL OFFICER)
(660) 265-4212
Entity
Organization
Contact information
Practice address
630 W 3RD ST, MILAN, MO 63556-1076
(660) 265-4212
(660) 265-4898
Mailing address
630 W 3RD ST, MILAN, MO 63556-1076
(660) 265-4212
(660) 265-4898
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
130-49
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
540324803
—
MO
Enumeration date
02/08/2007
Last updated
05/16/2011
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