Provider Demographics
NPI:1437116274
Name:SILVER SPRINGS SURGERY CENTER LLC
Entity Type:Organization
Organization Name:SILVER SPRINGS SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT CRNA
Authorized Official - Phone:573-332-1300
Mailing Address - Street 1:319 S SILVER SPRINGS RD
Mailing Address - Street 2:STE B
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703
Mailing Address - Country:US
Mailing Address - Phone:573-332-1300
Mailing Address - Fax:573-332-1550
Practice Address - Street 1:319 S SILVER SPRINGS RD
Practice Address - Street 2:STE B
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703
Practice Address - Country:US
Practice Address - Phone:573-332-1300
Practice Address - Fax:573-332-1550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO976261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO405137OtherHEALTHLINK
MO150194OtherBLUE CROSS