MISSOURI BAPTIST HOSPITAL OF SULLIVAN NPI 1184174567

NPI Information

NPI: 1184174567
Provider Name: MISSOURI BAPTIST HOSPITAL OF SULLIVAN

Doing Business As: BOURBON MEDICAL OFFICE

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
240 COLLEGE ST
BOURBON, MO
ZIP 65441
Phone: (573) 732-5004
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MISSOURI BAPTIST HOSPITAL OF SULLIVAN is a multi-specialty clinic center in Bourbon, MO. MISSOURI BAPTIST HOSPITAL OF SULLIVAN NPI is 1184174567. The provider is registered as an organization entity type.
The provider Is Doing Business As Bourbon Medical Office.

The provider's business location address is:

240 COLLEGE ST
BOURBON, MO
ZIP 65441-308
Phone: (573) 732-5004

The provider's authorized official is Tony L Schwarm .
The authorized official title is President and has the following contact phone number (573) 468-4186.

The CLIA number assigned to this NPI record is 26D0876487 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/10/2016 and was last updated on 3/23/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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