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General NPI Number Information
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NPI Number | 1578566758
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Entity Type | Organization
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Legal Business Name | ADVANCED AMBULATORY SURGICAL CARE, LP
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 10448 OLD OLIVE STREET RD STE 100
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City | CREVE COEUR
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State | MO
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Zip | 63141
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Country | US
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Telephone | 314-743-8091
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Fax | 314-743-8092
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Provider Business Mailing Address
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Address Line | 10448 OLD OLIVE STREET RD STE 100
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City | CREVE COEUR
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State | MO
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Zip | 63141-5927
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Country | US
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Telephone | 314-743-8091
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Fax | 314-743-8092
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | CHRIS HARTSHORN
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Credential |
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Telephone | 314-800-2017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 178
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License Number State | MO
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