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General NPI Number Information
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NPI Number | 1902795289
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Entity Type | Organization
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Legal Business Name | PACIFIC SURGERY CENTER LLC
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 111 1/2 S 90TH ST
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City | OMAHA
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State | NE
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Zip | 68114-3907
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Country | US
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Telephone | 402-397-7178
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Fax | 402-397-7591
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Provider Business Mailing Address
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Address Line | 10707 PACIFIC ST STE 100
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City | OMAHA
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State | NE
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Zip | 68114-4762
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Country | US
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Telephone | 402-397-7178
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Fax | 402-397-7591
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | AUDREY PERSON
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Credential |
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Telephone | 402-397-7178
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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 |
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License Number State |
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