Organization
NORTHERN NEVADA AMBULATORY SURGICAL CENTER LLC
Active
Other names
Surgical Arts Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACEY INGRAM (ADMINISTRATOR)
(775) 954-0600
Entity
Organization
Contact information
Practice address
5411 KIETZKE LANE, RENO, NV 89511
(775) 954-0600
(775) 954-0612
Mailing address
5411 KIETZKE LANE, RENO, NV 89511
(775) 954-0600
(775) 954-0612
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
2048ASC-12
NV
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
2048ASC-19
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004616009
—
NV
Enumeration date
04/10/2006
Last updated
06/02/2010
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