# SOUTH KANSAS CITY SURGICAL CENTER, LC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Kansas City Surgicenter
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114924685
- **Authorized official:** MRS. CHRISTINE BLACKBURN BSN, RN, CNOR (ADMINISTRATOR)
- **Authorized official phone:** (913) 901-9000

## Contact information

- **Practice address:** 10730 NALL AVE, SUITE 100, OVERLAND PARK, KS 66211-1206
- **Practice address phone:** (913) 901-9000
- **Practice address fax:** (913) 901-9030
- **Mailing address:** 10730 NALL AVE, SUITE 100, OVERLAND PARK, KS 66211-1206
- **Mailing address phone:** (913) 901-9000
- **Mailing address fax:** (913) 901-9030

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | S046019 | KS | Yes |

## Other

- **Enumeration date:** 06/30/2005
- **Last updated:** 07/30/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200310690A | — | KS |