| Missouri Baptist Sullivan Hospital | |
|
751 Sappington Bridge Rd Sullivan MO 63080-2354 | |
| (573) 468-4186 | |
| (573) 860-2696 |
| Full Name | Missouri Baptist Sullivan Hospital |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 751 Sappington Bridge Rd, Sullivan, Missouri |
| Authorized Official Name and Position | Tony L Schwarm (PRESIDENT) |
| Authorized Official Contact | 5734681343 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Missouri Baptist Sullivan Hospital 751 Sappington Bridge Rd Sullivan MO 63080-2354 Ph: (573) 468-1343 | Missouri Baptist Sullivan Hospital 751 Sappington Bridge Rd Sullivan MO 63080-2354 Ph: (573) 468-4186 |
| NPI Number | 1497763361 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 07/21/2022 |
| Certification Date | 03/23/2021 |
| Medicare PECOS PAC ID | 2668380148 |
|---|---|
| Medicare Enrollment ID | O20121011000008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497763361 | NPI | - | NPPES |
| 108 | Other | BLUE CROSS-BLUE SHIELD | |
| 800565004 | Medicaid | MO | |
| 489665 | Other | AETNA | |
| MI010565000 | Medicaid | MO | |
| 108 | Other | BLUE CHOICE | |
| 260115 | Other | PREMIER PLUS | |
| 540565009 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 355-24 (Missouri) | Primary |
Lifespan Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 625 Missouri Ave, Sullivan, MO 63080 Phone: 573-468-2121 Fax: 573-468-6121 | |
Advanced Psychiatric Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 751 Sappington Ridge Rd, Sullivan, MO 63080 Phone: 636-931-4206 Fax: 636-931-5774 |