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Organization
CREVE COEUR SURGERY CENTER LLC
Active
Organization
CREVE COEUR SURGERY CENTER LLC
Active
Other names
City Place Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLYN HOLLOWOOD R.N. (ADMINISTRATOR)
(314) 872-7100
Entity
Organization
Contact information
Practice address
845 N NEW BALLAS CT, SUITE 100, CREVE COEUR, MO 63141-7148
(314) 872-7100
(314) 872-0929
Mailing address
845 NORTH NEW BALLAS COURT, SUITE 100, CREVE COEUR, MO 63141-7148
(314) 872-7100
(314) 872-0929
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
110-4
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112514
BCBS PROVIDER NUMBER
MO
Enumeration date
09/30/2005
Last updated
08/22/2020
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