# MISSOURI BAPTIST HOSPITAL OF SULLIVAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cuba Medical Office
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396827408
- **Authorized official:** MR. TONY L SCHWARM (PRESIDENT)
- **Authorized official phone:** (573) 468-1343

## Contact information

- **Practice address:** 102 OZARK STREET, SUITE B, CUBA, MO 65453-1664
- **Practice address phone:** (573) 885-6600
- **Practice address fax:** (314) 996-3610
- **Mailing address:** 670 MASON RIDGE CENTER DR, SUITE 300, SAINT LOUIS, MO 63141-8573
- **Mailing address phone:** (314) 996-7644
- **Mailing address fax:** (314) 996-7658

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 355-24 | MO | Yes |

## Other

- **Enumeration date:** 10/19/2006
- **Last updated:** 03/23/2021