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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