MEDICARE: MIDWEST SURGERY CENTER INC

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	ASC044	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	ASC044	OTHER	NE	STATE LICENSE
3	07024	OTHER	NE	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1467580019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWEST SURGERY CENTER INC

Provider Business Mailing Address
First Line	:	PO BOX 241277
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68124-5277
Country	:	US
Telephone Number	:	402-331-6387
Fax Number	:	402-331-6537

Provider Business Practice Location Address
First Line	:	10784 V ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68127-2952
Country	:	US
Telephone Number	:	402-331-6387
Fax Number	:	402-331-6537

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL POWERS
Credential	:	DPM
Telephone Number	:	402-331-6387

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	04/30/2015

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Directions to “MIDWEST SURGERY CENTER INC ” Practice Location

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