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General NPI Number Information
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NPI Number | 1821074485
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Entity Type | Organization
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Legal Business Name | SURGERY CENTER OF FARMINGTON, L.L.C.
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 400 PARKLAND DR
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City | FARMINGTON
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State | MO
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Zip | 63640-2906
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Country | US
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Telephone | 573-756-8000
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Fax | 573-756-8288
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Provider Business Mailing Address
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Address Line | 400 PARKLAND DR
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City | FARMINGTON
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State | MO
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Zip | 63640-2906
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Country | US
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Telephone | 573-756-8000
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Fax | 573-756-8288
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CINDY ANN YOUNG
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Credential | R.N., C.A.S.C.
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Telephone | 573-756-8000
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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 | 101-6
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License Number State | MO
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