MEDICARE: CSA 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
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1457779399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CSA SURGICAL CENTER LLC

Provider Business Mailing Address
First Line	:	3220 BLUFF CREEK DR STE 104
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65201-3664
Country	:	US
Telephone Number	:	573-777-3370
Fax Number	:

Provider Business Practice Location Address
First Line	:	3220 BLUFF CREEK DR STE 104
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65201-3664
Country	:	US
Telephone Number	:	573-777-3370
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	JOHN G ADAMS
Credential	:
Telephone Number	:	573-777-3370

Provider Enumeration Date	:	03/28/2014
Last Update Date	:	02/24/2026

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