Organization
MISSOURI BAPTIST HOSPITAL OF SULLIVAN
Active
Other names
Bourbon Medical Office
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY L SCHWARM (PRESIDENT)
(573) 468-4186
Entity
Organization
Contact information
Practice address
240 COLLEGE ST, BOURBON, MO 65441-8308
(573) 732-5004
Mailing address
751 SAPPINGTON BRIDGE RD, ADMINISTRATION, SULLIVAN, MO 63080-2354
(573) 468-4186
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/10/2016
Last updated
03/23/2021
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