Organization
WEBSTER AMBULATORY SUGERY CENTER LP
Active
Other names
Sunset Hills Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENETHA D MORAN (AUTHORIZED OFFICIAL)
(972) 763-3893
Entity
Organization
Contact information
Practice address
12399 GRAVOIS RD, SUITE 102, SAINT LOUIS, MO 63127-1750
(314) 729-0100
(314) 729-0168
Mailing address
12399 GRAVOIS RD, SUITE 102, SAINT LOUIS, MO 63127-1750
(314) 729-0100
(314) 729-0168
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
270-0
STATE LICENSE
MO
Enumeration date
11/24/2015
Last updated
02/12/2016
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