Organization
MIDWEST SURGICAL HOSPITAL, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
7915 FARNAM DR., OMAHA, NE 68114-4504
(402) 399-1900
Mailing address
6128 S LYNCREST AVE, SIOUX FALLS, SD 57108-2560
(855) 327-6350
(605) 274-6186
Taxonomy
Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025662300
—
NE
05
—
1013122571
—
IA
01
—
60236
BLUE CROSS OF NEBRASKA
NE
01
—
613763400
US DEPARTMENT OF LABOR
NE
Enumeration date
05/10/2007
Last updated
01/04/2024
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