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Organization

COLONOSCOPY CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANDY STOCKTON (PRACTICE ADMINISTRATOR)
(402) 343-1122
Entity
Organization

Contact information

Practice address
9850 NICHOLAS STREET, SUITE 100, OMAHA, NE 68114
(402) 343-1122
(402) 343-1177
Mailing address
9850 NICHOLAS STREET, SUITE 100, OMAHA, NE 68114
(402) 343-1122
(402) 343-1177

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
ASC038
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0570762
IA
05
10025038900
NE
01
98448
BCBS OF IOWA
IA
01
D01791
BCBS OF NEBRASKA
NE
01
P00106867
RR MEDICARE PALMETO GPA
Enumeration date
07/07/2005
Last updated
11/02/2007
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