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Organization
PHYSICIANS SURGERY CENTER AT DEPAUL LLC
Active
Organization
PHYSICIANS SURGERY CENTER AT DEPAUL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAY MANGRICH (GROUP VICE PRESIDENT)
(913) 907-7907
Entity
Organization
Contact information
Practice address
12266 DEPAUL DRIVE, SUITE 10, BRIDGETON, MO 63044
(314) 291-7500
(314) 291-7501
Mailing address
12266 DEPAUL DRIVE, SUITE 10, BRIDGETON, MO 63044
(314) 291-7500
(314) 291-7501
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
08/12/2006
Last updated
08/22/2020
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