Organization
LAKESIDE AMBULATORY SURGICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA K WAGNER (CEO)
(402) 758-5212
Entity
Organization
Contact information
Practice address
17030 LAKESIDE HILLS PLZ STE 110, OMAHA, NE 68130-2440
(402) 758-5120
(402) 758-5087
Mailing address
17030 LAKESIDE HILLS PLZ STE 110, OMAHA, NE 68130-2440
(402) 758-5120
(402) 758-5087
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
05/03/2006
Last updated
11/13/2025
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