Provider Demographics
NPI:1487811063
Name:SURGEONS' FIRST, LLC
Entity type:Organization
Organization Name:SURGEONS' FIRST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNFA
Authorized Official - Prefix:MR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:B
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:636-933-2147
Mailing Address - Street 1:132 SUNRISE CT
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-2820
Mailing Address - Country:US
Mailing Address - Phone:636-933-2147
Mailing Address - Fax:636-933-3908
Practice Address - Street 1:132 SUNRISE CT
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-2820
Practice Address - Country:US
Practice Address - Phone:636-933-2147
Practice Address - Fax:636-933-3908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO069722163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty