ADVANCED SURGERY CENTER LLC; NPI #1619965324

Contact Information

ADVANCED SURGERY CENTER LLC

12607 OLIVE BLVD
SAINT LOUIS, MO 63141-6313

Phone: 314-205-1610
Fax: 314-205-1233
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulatory Surgical	261QA1903X	49	Ambulatory Surgical Center

Indicates primary specialty

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NPI Profile & details for ADVANCED SURGERY CENTER LLC

NPI # 1619965324

LBN Legal business name ADVANCED SURGERY CENTER LLC

Authorized official MELINDA SMITH - (ADMINISTRATOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/07/2005

Last updated 08/11/2014 - About 12 years ago

Identifiers

MO	License #	132-0
MO	Medicaid	506126200

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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