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Organization

GRAND ISLAND SURGICAL CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KEN TERRY (ADMINISTRATOR)
(308) 384-6400
Entity
Organization

Contact information

Practice address
3610 RICHMOND CIR, GRAND ISLAND, NE 68803-3927
(308) 384-6400
(308) 398-6420
Mailing address
PO BOX 5434, GRAND ISLAND, NE 68802-5434
(308) 384-6400
(308) 398-6420

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
ASC008
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01383
BCBS PROVIDER ID
NE
01
490004345
MEDICARE RR PROVIDER ID
NE
Enumeration date
05/23/2005
Last updated
06/23/2011
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