# SURGERY CENTER OF FREMONT, LLC

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

## Provider details

- **NPI number:** 1437102241
- **Authorized official:** JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
- **Authorized official phone:** (615) 234-5954

## Contact information

- **Practice address:** 2727 N CLARKSON ST, FREMONT, NE 68025-7713
- **Practice address phone:** (402) 727-8500
- **Practice address fax:** (402) 721-1065
- **Mailing address:** 2727 N CLARKSON ST, FREMONT, NE 68025-7713
- **Mailing address phone:** (402) 727-8500
- **Mailing address fax:** (402) 721-1065

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | ASC007 | NE | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 10/28/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1002537100 | — | NE |
| 01 | — | P00302981 | RR MEDICARE | — |