Organization
SHAWNEE MISSION SURGERY CENTER LLC
Active
Parent organization
SHAWNEE MISSION MEDICAL CENTER INC
Other names
AdventHealth Surgery Center Shawnee Mission
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHAWNEE MISSION MEDICAL CENTER INC
Authorized official
KARSTEN G RANDOLPH (EXEC VP & CFO)
(913) 676-2152
Entity
Organization
Contact information
Practice address
9301 W 74TH ST STE 300, MERRIAM, KS 66204-2239
(913) 632-9320
(913) 789-1886
Mailing address
7315 E FRONTAGE RD STE 200, MERRIAM, KS 66204-1658
(913) 676-7770
(913) 676-7776
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
S046018
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100415840A
—
KS
Enumeration date
07/01/2006
Last updated
12/11/2019
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