# FREMONT SURGICAL CENTER, LLC

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

## Provider details

- **NPI number:** 1649489832
- **Authorized official:** STEPHEN P HENRY (ADMINISTRATOR)
- **Authorized official phone:** (402) 941-7050

## Contact information

- **Practice address:** 840 E 29TH STREET, FREMONT, NE 68025
- **Practice address phone:** (402) 941-7050
- **Practice address fax:** (402) 941-7055
- **Mailing address:** 840 E 29TH STREET, FREMONT, NE 68025
- **Mailing address phone:** (402) 941-7050
- **Mailing address fax:** (402) 941-7055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | ASC052 | NE | Yes |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NE | — |

## Other

- **Enumeration date:** 05/22/2007
- **Last updated:** 07/23/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 10025569200 | — | NE |