Provider Demographics
NPI:1346383155
Name:BRIARCLIFF AMBULATORY SURGERY CENTER LP
Entity Type:Organization
Organization Name:BRIARCLIFF AMBULATORY SURGERY CENTER LP
Other - Org Name:BRIARCLIFF SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTSHORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-800-2017
Mailing Address - Street 1:4150 N MULBERRY DR
Mailing Address - Street 2:STE 100
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-1779
Mailing Address - Country:US
Mailing Address - Phone:816-214-4364
Mailing Address - Fax:816-214-4371
Practice Address - Street 1:4150 N MULBERRY DR
Practice Address - Street 2:STE 100
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-1779
Practice Address - Country:US
Practice Address - Phone:816-214-4364
Practice Address - Fax:816-214-4371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO162-1261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO507436400Medicaid
MOP00253038OtherMEDICARE RR
MO613892100OtherUS DEPT OF LABOR
MO91261011OtherBCBS
MO91261011OtherBCBS