Organization
PERRY COUNTY MEMORIAL HOSPITAL
Active
Parent organization
PERRY COUNTY MEMORIAL HOSPITAL
Other names
Troy Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
PERRY COUNTY MEMORIAL HOSPITAL
Authorized official
BRIAN HERWIG (CEO)
(812) 547-0170
Entity
Organization
Contact information
Practice address
315 MAIN ST., TROY, IN 47588
(812) 547-9552
(812) 547-9553
Mailing address
109 US HIGHWAY 66 E, TELL CITY, IN 47586-2755
(812) 547-9549
(812) 547-9543
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000374718
ANTHEM
IN
01
—
15D1043329
CLIA
IN
05
—
200531550A
—
IN
05
—
65944423
—
KY
05
—
78904778
—
KY
Enumeration date
11/09/2005
Last updated
02/21/2020
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