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Organization
SOUTH OMAHA SURGICAL CENTER LLC
Active
Organization
SOUTH OMAHA SURGICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL W BORVAN CRNA (VICE PRESIDENT)
(708) 253-7258
Entity
Organization
Contact information
Practice address
3201 S 24TH ST, OMAHA, NE 68108-1825
(402) 504-4071
(402) 504-4124
Mailing address
21120 WASHINGTON PKWY, FRANKFORT, IL 60423-3112
(815) 469-9750
(815) 469-9752
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
ASC068
NE
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
Other
Enumeration date
04/20/2015
Last updated
10/09/2017
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