Organization
ADVANCED AMBULATORY SURGICAL CARE, LP
Active
Other names
Advanced Surgical Care
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS HARTSHORN (AUTHORIZED OFFICIAL)
(314) 800-2017
Entity
Organization
Contact information
Practice address
10448 OLD OLIVE STREET RD, STE 100, CREVE COEUR, MO 63141
(314) 743-8091
(314) 743-8092
Mailing address
10448 OLD OLIVE STREET RD, STE 100, CREVE COEUR, MO 63141-5927
(314) 743-8091
(314) 743-8092
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
178
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192542
BC/BS
—
01
—
270644
GHP
—
05
—
507008902
—
MO
01
—
571197738
TRICARE
MO
01
—
688642
HEALTHLINK
—
01
—
P00181748
RR MEDICARE
MO
Enumeration date
05/23/2005
Last updated
09/18/2024
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