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Organization
CHESTERFIELD AMBULATORY SURGERY CENTER LP
Active
Organization
CHESTERFIELD AMBULATORY SURGERY CENTER LP
Active
Other names
Chesterfield Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER HARTSHORN (OFFICER/AUTHORIZED OFFICIAL)
(314) 800-2017
Entity
Organization
Contact information
Practice address
17050 BAXTER RD, STE 110, CHESTERFIELD, MO 63005-1422
(636) 537-0122
(636) 537-0480
Mailing address
17050 BAXTER RD, STE 110, CHESTERFIELD, MO 63005-1422
(636) 537-0122
(636) 537-0480
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
232-5
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
196128
GHP
MO
01
—
26D1023601
CLIA
MO
05
—
509077202
—
MO
01
—
610832100
DEPT. OF LABOR
MO
01
—
P00338546
RAILROAD MEDICARE
MO
Enumeration date
06/11/2006
Last updated
10/04/2024
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