| Organization Name: | MISSOURI BAPTIST HOSPITAL OF SULLIVAN |
| NPI Number: | 1235228222 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TONY L SCHWARM (PRESIDENT) |
| Mailing Address: | 965 Mattox Dr Sullivan |
| State: | MO US |
| Postal Code: | 630802365 |
| Phone Number: | 5734864186 |
| Fax Number: | 3149963610 |
| NPI Enumeration Date: | 10/11/2006 |
| NPI Last Update Date: | 01/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | 355-24 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |