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General NPI Number Information
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NPI Number | 1831180272
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Entity Type | Organization
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Legal Business Name | ADVANCED ENDOSCOPY CENTER LLC
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Dates
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Enumeration Date | 11/03/2005
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 11525 OLDE CABIN ROAD SUITE 101
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City | CREVE COEUR
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State | MO
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Zip | 63141-7146
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Country | US
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Telephone | 314-400-9999
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Fax | 314-400-9990
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Provider Business Mailing Address
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Address Line | 11525 OLDE CABIN ROAD SUITE 101
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City | CREVE COEUR
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State | MO
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Zip | 63141-7146
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Country | US
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Telephone | 314-400-9999
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Fax | 314-400-9990
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Authorized Official
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Title or Position | OFFICER/AUTHORIZED OFFICIAL
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Name | CHRISTOPHER 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 |
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License Number State |
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