Organization
MISSOURI BAPTIST HOSPITAL OF SULLIVAN
Active
Other names
Cuba Medical Office
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY L SCHWARM (PRESIDENT)
(573) 468-1343
Entity
Organization
Contact information
Practice address
102 OZARK STREET, SUITE B, CUBA, MO 65453-1664
(573) 885-6600
(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
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE7443
MEDICARE RAILRAOD
MO
Enumeration date
10/19/2006
Last updated
03/23/2021
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