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Organization
SURGERY CENTER OF FREMONT, LLC
Active
Organization
SURGERY CENTER OF FREMONT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
2727 N CLARKSON ST, FREMONT, NE 68025-7713
(402) 727-8500
(402) 721-1065
Mailing address
2727 N CLARKSON ST, FREMONT, NE 68025-7713
(402) 727-8500
(402) 721-1065
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
ASC007
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002537100
—
NE
01
—
P00302981
RR MEDICARE
—
Enumeration date
05/19/2006
Last updated
10/28/2022
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