MEDICARE: ST. MARY'S OUTPATIENT SURGERY CENTER AT GALENA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center		NV

General Provider Information

NPI Number	:	1295973006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. MARY'S OUTPATIENT SURGERY CENTER AT GALENA LLC

Provider Business Mailing Address
First Line	:	18653 WEDGE PKWY STE 170
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-3037
Country	:	US
Telephone Number	:	775-674-5200
Fax Number	:	775-657-8043

Provider Business Practice Location Address
First Line	:	18653 WEDGE PKWY STE 170
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-3037
Country	:	US
Telephone Number	:	775-674-5200
Fax Number	:	775-674-5228

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	LARS WEBB
Credential	:	MD
Telephone Number	:	775-674-5200

Provider Enumeration Date	:	02/02/2009
Last Update Date	:	03/05/2026

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