| Sullivan County Community Hospital | |
|
4146 S 7th St Ste B Terre Haute IN 47802-4123 | |
| (812) 268-4311 | |
| Not Available |
| Full Name | Sullivan County Community Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 4146 S 7th St Ste B, Terre Haute, Indiana |
| Authorized Official Name and Position | Darrell D Watson (DIRECTOR REVENUE CYCLE) |
| Authorized Official Contact | 8122684311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sullivan County Community Hospital Po Box 10 Sullivan IN 47882-0010 Ph: (812) 268-4311 | Sullivan County Community Hospital 4146 S 7th St Ste B Terre Haute IN 47802-4123 Ph: (812) 268-4311 |
| NPI Number | 1366076564 |
|---|---|
| Provider Enumeration Date | 02/26/2020 |
| Last Update Date | 02/26/2020 |
| Medicare PECOS PAC ID | 2466497482 |
|---|---|
| Medicare Enrollment ID | O20200414001364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366076564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Daniel Choyce Callahan |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1255580593 PECOS PAC ID: 5092970913 Enrollment ID: I20180725001713 |
| Provider Name | Robert Ealy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720664048 PECOS PAC ID: 2567879158 Enrollment ID: I20210326000976 |
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