| Missouri Baptist Hospital Of Sullivan | |
| 
					240 College St Bourbon MO 65441-8308  | |
| (573) 732-5140 | |
| (314) 996-3610 | 
| Full Name | Missouri Baptist Hospital Of Sullivan | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 240 College St, Bourbon, Missouri | 
| Authorized Official Name and Position | Tony Schwarm (PRESIDENT) | 
| Authorized Official Contact | 5734684186 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Missouri Baptist Hospital Of Sullivan 670 Mason Ridge Center Dr Suite 300 Saint Louis MO 63141-8573 Ph: (314) 996-7644  | Missouri Baptist Hospital Of Sullivan 240 College St Bourbon MO 65441-8308 Ph: (573) 732-5140  | 
| NPI Number | 1326131475 | 
|---|---|
| Provider Enumeration Date | 10/02/2006 | 
| Last Update Date | 03/23/2021 | 
| Medicare PECOS PAC ID | 2668380148 | 
|---|---|
| Medicare Enrollment ID | O20051205000413 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1326131475 | NPI | - | NPPES | 
| CE7443 | Other | MO | MEDICARE RAILROAD | 
| CG2664 | Other | MO | MEDICARE RAILROAD | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 355-24 (Missouri) | Primary | 
Patients First Health Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 125 N. Old Highway 66, Bourbon, MO 65541 Phone: 573-679-2006 Fax: 573-679-2003  | |
South Central Missouri Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 246 College St, Bourbon, MO 65441 Phone: 573-426-2407 Fax: 573-426-2407  | |
Missouri Baptist Hospital Of Sullivan Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 240 College St, Bourbon, MO 65441 Phone: 573-732-5004  | |
Mercy Clinic East Communities Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 125 N Old Highway 66, Bourbon, MO 65441 Phone: 573-679-2006  |