MEDICARE: MERCURY SURGERY 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	1730	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538262118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCURY SURGERY CENTER LLC

Provider Business Mailing Address
First Line	:	901 HEARTLAND DRIVE
Second Line	:	SUITE 1820
City	:	ST JOSEPH
State	:	MO
Zip	:	64506-6201
Country	:	US
Telephone Number	:	816-364-2772
Fax Number	:	816-364-6620

Provider Business Practice Location Address
First Line	:	901 HEARTLAND DRIVE
Second Line	:	SUITE 1820
City	:	ST JOSEPH
State	:	MO
Zip	:	64506-6201
Country	:	US
Telephone Number	:	816-364-2772
Fax Number	:	816-364-6620

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KRIKOR O PARTAMIAN
Credential	:	MD
Telephone Number	:	816-232-8877

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	06/13/2013

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Directions to “MERCURY SURGERY CENTER LLC ” Practice Location

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