Organization
MANCHESTER AMBULATORY SURGERY CENTER LP
Active
Other names
Des Peres Square Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER HARTSHORN (OFFICER/AUTHORIZED OFFICIAL)
(314) 800-2017
Entity
Organization
Contact information
Practice address
1050 OLD DES PERES RD, SUITE 150, SAINT LOUIS, MO 63131-1873
(314) 569-2918
(314) 569-9473
Mailing address
1050 OLD DES PERES RD STE 150, SAINT LOUIS, MO 63131-1874
(314) 569-2918
(314) 569-9473
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171
LICENSE
MO
Enumeration date
03/12/2015
Last updated
10/11/2024
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