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Organization
MISSOURI BAPTIST HOSPITAL OF SULLIVAN
Active
Organization
MISSOURI BAPTIST HOSPITAL OF SULLIVAN
Active
Other names
Bourbon Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY SCHWARM (PRESIDENT)
(573) 468-4186
Entity
Organization
Contact information
Practice address
240 COLLEGE ST, BOURBON, MO 65441-8308
(573) 732-5140
(314) 996-3610
Mailing address
670 MASON RIDGE CENTER DR, SUITE 300, SAINT LOUIS, MO 63141-8573
(314) 996-7644
(314) 996-7658
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
355-24
MO
Other
Enumeration date
10/02/2006
Last updated
03/23/2021
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