Organization
LIFE LINE SURGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DELLA ARIDGE NP (NURSE/MANAGER)
(314) 591-1125
Entity
Organization
Contact information
Practice address
10004 KENNERLY RD, SUITE 330-A, SAINT LOUIS, MO 63128-2141
(314) 718-9947
(314) 718-9947
Mailing address
10004 KENNERLY RD, SUITE 330-A, SAINT LOUIS, MO 63128-2141
(314) 718-9947
(314) 718-9947
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
33400
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407950017
INDIVIDUAL NPI
MO
01
—
16010260
CPIN
MO
Enumeration date
11/23/2009
Last updated
02/07/2023
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