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Organization
NORTHERN NEVADA AMBULATORY SURGICAL CENTER LLC
Active
Organization
NORTHERN NEVADA AMBULATORY SURGICAL CENTER LLC
Active
Other names
Surgical Arts Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACEY INGRAM (ADMINISTRATOR)
(775) 954-0600
Entity
Organization
Contact information
Practice address
5411 KIETZKE LANE, RENO, NV 89511
(775) 954-0600
(775) 954-0612
Mailing address
5411 KIETZKE LANE, RENO, NV 89511
(775) 954-0600
(775) 954-0612
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
2048ASC-12
NV
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
2048ASC-19
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004616009
—
NV
Enumeration date
04/10/2006
Last updated
06/02/2010
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