MEDICARE: WEST COUNTY 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

General Provider Information

NPI Number	:	1659339349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST COUNTY SURGERY CENTER LP

Provider Business Mailing Address
First Line	:	1130 TOWN AND COUNTRY COMMONS
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-8200
Country	:	US
Telephone Number	:	636-394-0698
Fax Number	:

Provider Business Practice Location Address
First Line	:	1130 TOWN AND COUNTRY COMMONS
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-8200
Country	:	US
Telephone Number	:	636-394-0698
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KIMBERLY WOOD
Credential	:
Telephone Number	:	828-236-3027

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	08/31/2007

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