# NORTHERN NEVADA AMBULATORY SURGICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Surgical Arts Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699738872
- **Authorized official:** MRS. STACEY INGRAM (ADMINISTRATOR)
- **Authorized official phone:** (775) 954-0600

## Contact information

- **Practice address:** 5411 KIETZKE LANE, RENO, NV 89511
- **Practice address phone:** (775) 954-0600
- **Practice address fax:** (775) 954-0612
- **Mailing address:** 5411 KIETZKE LANE, RENO, NV 89511
- **Mailing address phone:** (775) 954-0600
- **Mailing address fax:** (775) 954-0612

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 2048ASC-12 | NV | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 2048ASC-19 | NV | Yes |

## Other

- **Enumeration date:** 04/10/2006
- **Last updated:** 06/02/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004616009 | — | NV |