Healthcare Provider Details

I. General information

NPI: 1124740915
Provider Name (Legal Business Name): 314 SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 05/05/2025
Certification Date: 09/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2840 CLARK AVE
SAINT LOUIS MO
63103-2506
US

IV. Provider business mailing address

2840 CLARK AVE
ST. LOUIS MO
63103-2506
US

V. Phone/Fax

Practice location:
  • Phone: 314-949-3066
  • Fax: 314-260-9806
Mailing address:
  • Phone: 314-949-3066
  • Fax: 314-260-9806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SWASTIK KUMAR SINHA
Title or Position: MEDICAL DIRECTOR/OWNER
Credential: M.D.
Phone: 314-949-3066