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General NPI Number Information
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NPI Number | 1558337790
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Entity Type | Organization
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Legal Business Name | KEARNEY AMBULATORY SURGICAL CENTER, LLC
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 3515 30TH AVE
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City | KEARNEY
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State | NE
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Zip | 68845-2298
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Country | US
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Telephone | 308-865-2670
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Fax | 308-865-2876
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Provider Business Mailing Address
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Address Line | 3515 30TH AVE
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City | KEARNEY
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State | NE
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Zip | 68845-2298
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Country | US
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Telephone | 308-865-2670
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Fax | 308-865-2876
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JODY L DELAHUNTY
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Credential | RN, BSN, CNOR
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Telephone | 308-865-2670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | ASC030
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License Number State | NE
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