# NORTHEAST NEBRASKA SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Faith Regional Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861497380
- **Authorized official:** KELLY A. DRISCOLL (MEMBER OF BOARD OF MANAGERS)
- **Authorized official phone:** (402) 644-7637

## Contact information

- **Practice address:** 2701 W NORFOLK AVE, STE 101, NORFOLK, NE 68701-4408
- **Practice address phone:** (402) 644-7262
- **Practice address fax:** (402) 644-7227
- **Mailing address:** 2701 W NORFOLK AVE, STE 101, NORFOLK, NE 68701-4408
- **Mailing address phone:** (402) 644-7262
- **Mailing address fax:** (402) 644-7227

## Taxonomy

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

## Other

- **Enumeration date:** 06/21/2005
- **Last updated:** 02/24/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01307 | BCBS | NE |
| 05 | — | 0719674 | — | IA |
| 01 | — | 490004329 | RR MEDICARE | NE |
| 01 | — | F885 | MIDLANDS CHOICE | NE |