1346383155 NPI number — BRIARCLIFF AMBULATORY SURGERY CENTER LP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346383155 NPI number — BRIARCLIFF AMBULATORY SURGERY CENTER LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIARCLIFF AMBULATORY SURGERY CENTER LP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346383155
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4150 N MULBERRY DR
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64116-1779
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-214-4364
Provider Business Mailing Address Fax Number:
816-214-4371

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4150 N MULBERRY DR
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64116-1779
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-214-4364
Provider Business Practice Location Address Fax Number:
816-214-4371
Provider Enumeration Date:
02/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HARTSHORN
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
Authorized Official Title or Position:
AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
314-800-2017

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  162-1 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 507436400 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 613892100 . This is a "US DEPT OF LABOR" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 91261011 . This is a "BCBS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: P00253038 . This is a "MEDICARE RR" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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