Healthcare Provider Details

I. General information

NPI: 1467580019
Provider Name (Legal Business Name): MIDWEST SURGERY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 04/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10784 V ST
OMAHA NE
68127-2952
US

IV. Provider business mailing address

PO BOX 241277
OMAHA NE
68124-5277
US

V. Phone/Fax

Practice location:
  • Phone: 402-331-6387
  • Fax: 402-331-6537
Mailing address:
  • Phone: 402-331-6387
  • Fax: 402-331-6537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberASC044
License Number StateNE

VIII. Authorized Official

Name: DR. MICHAEL POWERS
Title or Position: OWNER
Credential: DPM
Phone: 402-331-6387