Organization
MISSOURI BAPTIST HOSPITAL OF SULLIVAN
Active
Other names
Missouri Baptist Sullivan Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY L SCHWARM (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
273R00000X
Psychiatric Hospital Unit
Primary
355-24
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108
BLUE CROSS-BLUE SHIELD
—
01
—
260115
PREMIER PLUS
—
01
—
489665
AETNA
—
05
—
540565009
—
MO
05
—
800565004
—
MO
05
—
MI010565000
—
MO
Enumeration date
08/04/2006
Last updated
07/21/2022
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