Healthcare Provider Details

I. General information

NPI: 1982053054
Provider Name (Legal Business Name): WEBSTER AMBULATORY SURGERY CENTER, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2016
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9701 LANDMARK PARKWAY DR SUITE 100
SAINT LOUIS MO
63127-1665
US

IV. Provider business mailing address

9701 LANDMARK PARKWAY DR SUITE 100
SAINT LOUIS MO
63127-1665
US

V. Phone/Fax

Practice location:
  • Phone: 972-763-3893
  • Fax: 972-692-6745
Mailing address:
  • Phone: 972-763-3893
  • Fax: 972-692-6745

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: CHRISTOPHER HARTSHORN
Title or Position: OFFICER / AUTHORIZED OFFICIAL
Credential:
Phone: 314-800-2017