| Sullivan Medical Office | |
|
965 Mattox Dr Sullivan MO 63080-2365 | |
| (573) 486-4186 | |
| (314) 996-3610 |
| Full Name | Sullivan Medical Office |
|---|---|
| Speciality | Clinic/Center |
| Location | 965 Mattox Dr, 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 |
|---|---|
| Sullivan Medical Office 670 Mason Ridge Center Dr Suite 300 Saint Louis MO 63141-8573 Ph: (314) 996-7644 | Sullivan Medical Office 965 Mattox Dr Sullivan MO 63080-2365 Ph: (573) 486-4186 |
| NPI Number | 1235228222 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 03/23/2021 |
| Medicare PECOS PAC ID | 2668380148 |
|---|---|
| Medicare Enrollment ID | O20051205000387 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235228222 | 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 |
Mercy Clinic East Communities Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1326 S Service Rd W Ste 20, Sullivan, MO 63080 Phone: 573-468-3555 | |
Premier Health Center, L.l.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 Progress Pkwy, Sullivan, MO 63080 Phone: 573-468-6011 Fax: 573-468-7868 | |
Patients First Health Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 Progress Pkwy, Sullivan, MO 63080 Phone: 573-468-3555 Fax: 573-468-3554 | |
Patients First Health Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 450 Cumberland Way Ste A, Sullivan, MO 63080 Phone: 573-468-2006 Fax: 573-468-2026 | |
Compass Health, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 101 Progress Pkwy, Sullivan, MO 63080 Phone: 660-890-8186 | |
Sullivan Medical Office Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 965 Mattox Dr, Sullivan, MO 63080 Phone: 573-860-6000 |