| Organization Name: | CREVE COEUR SURGERY CENTER, LLC |
| NPI Number: | 1003110792 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES P. EMMANUEL (BOARD PRESIDENT) |
| Mailing Address: | 845 N New Ballas Ct Suite 100 Creve Coeur |
| State: | MO US |
| Postal Code: | 631417134 |
| Phone Number: | 3148727100 |
| Fax Number: | |
| NPI Enumeration Date: | 01/10/2011 |
| NPI Last Update Date: | 03/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 110-9 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |