SULLIVAN COUNTY COMMUNITY HOSPITAL (NPI# 1366076564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366076564 |
| Entity Type | Organization |
| Organization Name | SULLIVAN COUNTY COMMUNITY HOSPITAL |
| Practice Address |
4146 S 7th St Ste B Terre Haute IN 47802-4123 |
| Mailing Address |
Po Box 10 Sullivan IN 47882-0010 |
| Practice Telephone | 8122684311 |
| Mailing Telephone | 8122684311 |
| Mailing Fax Number | 8122682544 |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2020-02-26 |
| Authorized Official Name | MR. DARRELL D WATSON (DIRECTOR REVENUE CYCLE) |
| Authorized Official Telephone | 8122684311 |
| Is Organization Subpart | Y |
| Parent Organization Name | SULLIVAN COUNTY COMMUNITY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Sullivan Pain Management Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497759260 | Sullivan County Community Hospital | General Acute Care Hospital | 2200 N Section St, Sullivan, IN 47882-7523 | 2005-06-09 |
| 1790788537 | Sullivan County Community Hospital | Home Health | 2110 N Hospital Blvd Ste 3, Sullivan, IN 47882-7656 | 2005-05-24 |
| 1093323701 | Sullivan County Community Hospital | Clinic/Center | 2186 N Hospital Blvd Ste 2, Sullivan, IN 47882-7654 | 2020-07-20 |
| 1497363303 | Sullivan County Community Hospital | Family Medicine | 2186 N Hospital Blvd Ste 2, Sullivan, IN 47882-7654 | 2020-07-16 |
| 1154939320 | Sullivan County Community Hospital | Clinic/Center | 2200 N Section St, Sullivan, IN 47882-7523 | 2020-07-14 |
| 1447805965 | Sullivan County Community Hospital | Family Medicine | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2019-08-02 |
| 1467884643 | Sullivan County Community Hospital | Clinic/Center | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2013-07-30 |
| 1275827206 | Sullivan County Community Hospital | Clinic/Center | 8685 Old Highway 41 South, Carlisle, IN 47838-8234 | 2011-06-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SULLIVAN COUNTY COMMUNITY HOSPITAL | 2200 N Section St, Sullivan, IN 47882-7523 |
| Indiana Business Entities | SULLIVAN COUNTY COMMUNITY HOSPITAL | Formed Pursuant To Ic 16-22-8-6, "other Entity" Under 23-15-1-5-, To Provide for Assumed Name, ., IN |
| Street Address |
4146 S 7TH ST STE B |
| City | TERRE HAUTE |
| State | IN |
| Zip Code | 47802-4123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184242364 | Sowjanya Gunukula | Dentist | 3359 S Us Hwy 41, Terre Haute, IN 47802 | 2020-07-14 |
| 1366005027 | Irma D Davis Lmft | Marriage & Family Therapist | 1400 South Pugh Drive, Suite #3, Terre Haute, IN 47802 | 2019-04-18 |
| 1255892543 | Darcie Jo Antony | Dietitian, Registered | 3901 South 7th St, Dietitian's Office 4th Floor, Terre Haute, IN 47802 | 2019-03-28 |
| 1548726003 | James Brian Levenson | Nurse Practitioner | 670 Margaret Dr, Terre Haute, IN 47802 | 2019-02-20 |
| 1972011815 | Wellness for Life Medical LLC | Clinic/Center | 3487 S 4th St, Terre Haute, IN 47802 | 2018-01-12 |
| 1992211965 | Megan Elizabeth Marietta | Nurse Practitioner | 3487 S 4th Street, Terre Haute, IN 47802 | 2017-12-28 |
| 1396187944 | Marc Keilman | Pharmacist | 1240 E Hook Dr, Terre Haute, IN 47802 | 2013-07-24 |
| 1043563364 | Indiana Hearing LLC | Hearing Aid Equipment | 3181 S 3rd Pl, Terre Haute, IN 47802 | 2012-10-24 |
| 1619241783 | Michael James Elkins Shanks | Urology | 3401 S 4th St, Terre Haute, IN 47802 | 2012-03-06 |
| 1073890208 | Christopher Allan Blila | Nurse Practitioner | 4700 Bureau Road South, Terre Haute, IN 47802 | 2011-11-16 |
| Find all providers in zip 47802 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891044681 | Wabash Valley Health Center, Inc. | Clinic/Center | 1436 Locust Street, Terre Haute, IN 47807-1648 | 2012-09-07 |
| 1316205115 | Fountain of Youth, LLC | Clinic/Center | 8810 Wabash Ave, Terre Haute, IN 47803-3908 | 2012-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679170 | Gentlemind Health Services | Clinic/Center | 3635 Lake Ave, Fort Wayne, IN 46805-5539 | 2020-11-02 |
| 1063021129 | Affordable Lab Solutions | Clinic/Center | 1121 16th St, Bedford, IN 47421-3721 | 2020-07-24 |
| 1568071710 | Ivx Health of Indiana PC | Clinic/Center | 9510 N Meridian St Ste D, Indianapolis, IN 46260-1333 | 2020-07-23 |
| 1346867942 | Henry County Memorial Hospital | Clinic/Center | 4760 National Rd W, Richmond, IN 47374-4745 | 2020-06-30 |
| 1114541935 | Ourhealth Physicians Group, LLC | Clinic/Center | 9998 N Michigan Rd, Carmel, IN 46032-9640 | 2020-06-08 |
| 1497306310 | Activate Healthcare - Ibew Local 153/ua Local 172 South Bend | Clinic/Center | 3371 W Cleveland Road Ext Ste 120, South Bend, IN 46628-9780 | 2019-09-23 |
| 1437707601 | Nuyou Therapies, LLC | Clinic/Center | 5401 Vogel Rd Ste 740, Evansville, IN 47715-7834 | 2019-08-29 |
| 1306492160 | Deaconess Clinic, Inc. | Clinic/Center | 315 N 1st Ave, Evansville, IN 47710-1218 | 2019-08-16 |
| 1750941902 | Unity Healthcare LLC | Clinic/Center | 1345 Unity Pl Ste 220, Lafayette, IN 47905-5761 | 2019-06-19 |
| 1538622899 | Transitions Recovery, LLC | Clinic/Center | 2406 G St, Bedford, IN 47421-5120 | 2019-04-12 |
| Find all providers with the same taxonomy | ||||
| City | TERRE HAUTE |
| Zip Code | 47802 |
Please comment or provide details below to improve the information on SULLIVAN COUNTY COMMUNITY HOSPITAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.