Organization
CAPE GIRARDEAU OUTPATIENT SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZIE VICKERY RN (SURGERY ADMINISTRATOR)
(573) 335-9175
Entity
Organization
Contact information
Practice address
1429 N MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63701-2171
(573) 335-9175
(573) 334-3390
Mailing address
1429 N MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63701-2171
(573) 335-9175
(573) 334-3390
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
53-12
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
052418
HEALTH ALLIANCE
MO
01
—
107822
GROUP HEALTH PLAN
MO
01
—
1525586
UMWA
MO
01
—
241640
HEALTHLINK
MO
01
—
28
BLUECROSS BLUESHIELD
MO
Enumeration date
04/05/2006
Last updated
04/20/2008
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