# LAKESIDE ENDOSCOPY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407992241
- **Authorized official:** KIMBERLY S HARMON MD (MD)
- **Authorized official phone:** (402) 397-7057

## Contact information

- **Practice address:** 17001 LAKESIDE HILLS PLZ, SUITE 201, OMAHA, NE 68130
- **Practice address phone:** (402) 614-2300
- **Practice address fax:** (402) 505-4738
- **Mailing address:** 8901 INDIAN HILLS DR, SUITE 200, OMAHA, NE 68114
- **Mailing address phone:** (402) 505-4713
- **Mailing address fax:** (402) 505-4738

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | ASC054 | NE | Yes |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 01/29/2007
- **Last updated:** 05/08/2024