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NPI Code Detail

MEDICARE: PREMIER SURGICAL CENTER LLC

MEDICARE: PREMIER SURGICAL CENTER LLC
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
1261QA1903XAmbulatory Surgical Clinic/CenterMO

General Provider Information

NPI Number : 1447613344
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIER SURGICAL CENTER LLC
Provider Business Mailing Address
First Line : 11155 DUNN RD STE 304E
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63136-6111
Country : US
Telephone Number : 314-741-0911
Fax Number : 314-741-0501
Provider Business Practice Location Address
First Line : 3550 MCKELVEY RD
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2527
Country : US
Telephone Number : 314-218-9655
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MEGAN THOMAS
Credential :
Telephone Number : 224-285-6266
Provider Enumeration Date : 03/30/2016
Last Update Date : 01/29/2026

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Directions to “PREMIER SURGICAL CENTER LLC ” Practice Location

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