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NPI Code Detail

MEDICARE: SAINT MARY'S OUTPATIENT SURGERY CENTER AT GALENA

MEDICARE: SAINT MARY'S OUTPATIENT SURGERY CENTER AT GALENA
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
1261QA1903XAmbulatory Surgical Clinic/CenterB0506616NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

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

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Directions to “SAINT MARY'S OUTPATIENT SURGERY CENTER AT GALENA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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