Organization
MISSOURI BAPTIST HOSPITAL OF SULLIVAN
Active
Organization
MISSOURI BAPTIST HOSPITAL OF SULLIVAN
Active
Other names
Missouri Baptist Sullivan Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY SCHWARM II (PRESIDENT)
(573) 468-1343
Entity
Organization
Contact information
Practice address
751 SAPPINGTON BRIDGE RD, SULLIVAN, MO 63080-2354
(573) 468-4186
(573) 860-2696
Mailing address
751 SAPPINGTON BRIDGE RD, SULLIVAN, MO 63080-2354
(573) 468-1343
(573) 860-2696
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
355-24
MO
282NC0060X
Critical Access Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108
BLUE CHOICE
—
01
—
260115
PREMIER PLUS
—
01
—
489665
AETNA
—
05
—
540565009
—
MO
05
—
800565004
—
MO
05
—
MI010565000
—
MO
Enumeration date
08/09/2006
Last updated
07/21/2022
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