BLACK RIVER AMBULATORY SURGERY CENTER LLC NPI 1770149304

NPI Information

NPI: 1770149304
Provider Name: BLACK RIVER AMBULATORY SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
219 PHYSICIANS PARK
POPLAR BLUFF, MO
ZIP 63901
Phone: (573) 609-2444
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BLACK RIVER AMBULATORY SURGERY CENTER, LLC is an ambulatory surgical clinic center in Poplar Bluff, MO. BLACK RIVER AMBULATORY SURGERY CENTER, LLC NPI is 1770149304. The provider is registered as an organization entity type.

The provider's business location address is:

219 PHYSICIANS PARK
POPLAR BLUFF, MO
ZIP 63901-956
Phone: (573) 609-2444

The provider's authorized official is David C Prather .
The authorized official title is Chief Financial Officer and has the following contact phone number (573) 331-5129.

The enumeration date for this NPI number is 5/20/2019 and was last updated on 5/20/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			No
2	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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