# COLONOSCOPY CENTER INC

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

## Provider details

- **NPI number:** 1427056100
- **Authorized official:** ANDY STOCKTON (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (402) 343-1122

## Contact information

- **Practice address:** 9850 NICHOLAS STREET, SUITE 100, OMAHA, NE 68114
- **Practice address phone:** (402) 343-1122
- **Practice address fax:** (402) 343-1177
- **Mailing address:** 9850 NICHOLAS STREET, SUITE 100, OMAHA, NE 68114
- **Mailing address phone:** (402) 343-1122
- **Mailing address fax:** (402) 343-1177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | ASC038 | NE | Yes |

## Other

- **Enumeration date:** 07/07/2005
- **Last updated:** 11/02/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0570762 | — | IA |
| 05 | — | 10025038900 | — | NE |
| 01 | — | 98448 | BCBS OF IOWA | IA |
| 01 | — | D01791 | BCBS OF NEBRASKA | NE |
| 01 | — | P00106867 | RR MEDICARE PALMETO GPA | — |