Organization
PACIFIC SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUCLID DESOUZA (BOARD MEMBER)
(402) 391-2166
Entity
Organization
Contact information
Practice address
10707 PACIFIC ST STE 100, OMAHA, NE 68114-4762
(402) 933-1844
(402) 932-5891
Mailing address
6128 S LYNCREST AVE, SIOUX FALLS, SD 57108-2560
(855) 334-2955
(605) 274-6186
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA2347
PTAN
NE
Enumeration date
07/24/2012
Last updated
08/19/2013
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