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General NPI Number Information
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NPI Number | 1770660706
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Entity Type | Organization
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Legal Business Name | SAINT MARY'S OUTPATIENT SURGERY CENTER AT GALENA
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 02/04/2010
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Provider Practice Location Address
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Address Line | 18653 WEDGE PKWY
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City | RENO
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State | NV
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Zip | 89511-3005
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Country | US
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Telephone | 775-770-7218
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Fax | 775-770-7228
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Provider Business Mailing Address
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Address Line | 18653 WEDGE PKWY
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City | RENO
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State | NV
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Zip | 89511-3005
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Country | US
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Telephone | 775-770-7218
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Fax | 775-770-7228
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Authorized Official
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Title or Position | EXECUTIVE VP - COO
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Name | MR. JOSEPH E JASMON
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Credential |
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Telephone | 775-770-6085
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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 | B0506616
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License Number State | NV
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