Organization
MISSOURI BAPTIST HOSPITAL OF SULLIVAN
Active
Other names
Sullivan Medical Office
Organization subpart
No
Provider details
NPI number
Authorized official
LISA LYNNE LOCHNER (PRESIDENT)
(573) 860-6000
Entity
Organization
Contact information
Practice address
751 SAPPINGTON BRIDGE RD, SULLIVAN, MO 63080-2354
(573) 468-4186
Mailing address
670 MASON RIDGE CENTER DR STE 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
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE7443
MEDICARE RAILROAD
MO
01
—
CG2664
MEDICARE RAILROAD
MO
Enumeration date
10/11/2006
Last updated
09/17/2025
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