MEDICARE: WEBSTER AMBULATORY SURGERY CENTER LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	202-2	MO

General Provider Information

NPI Number	:	1235146325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEBSTER AMBULATORY SURGERY CENTER LP

Provider Business Mailing Address
First Line	:	520 S ELM AVE
Second Line	:
City	:	WEBSTER GROVES
State	:	MO
Zip	:	63119-3845
Country	:	US
Telephone Number	:	314-962-3464
Fax Number	:	314-962-0369

Provider Business Practice Location Address
First Line	:	520 S ELM AVE
Second Line	:
City	:	WEBSTER GROVES
State	:	MO
Zip	:	63119-3845
Country	:	US
Telephone Number	:	314-962-3464
Fax Number	:	314-962-0369

Authorized Official
Title or Position	:	OFFICER, AUTHORIZED OFFICIAL
Name	:	KATHERINE L REED
Credential	:
Telephone Number	:	972-763-3859

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	03/23/2015

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