Organization
SULLIVAN COUNTY COMMUNITY HOSPITAL
Active
Parent organization
SULLIVAN COUNTY COMMUNITY HOSPITAL
Other names
Sullivan County Community Hospital Home Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
SULLIVAN COUNTY COMMUNITY HOSPITAL
Authorized official
MS. KENISHA J. SIMMONS RN (DIRECTOR)
(812) 268-4311
Entity
Organization
Contact information
Practice address
2110 N HOSPITAL BLVD STE 3, SULLIVAN, IN 47882-7656
(812) 268-4311
(812) 268-2654
Mailing address
PO BOX 10, 2110 N. HOSPITAL BLVD, SUITE #3, SULLIVAN, IN 47882-0010
(812) 268-4311
(812) 268-2654
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
05-003248-1
IN
251E00000X
Home Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200387670A
—
IN
Enumeration date
05/24/2005
Last updated
07/15/2014
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