Organization
NORTHEAST NEBRASKA SURGERY CENTER LLC
Active
Other names
Faith Regional Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY A. DRISCOLL (MEMBER OF BOARD OF MANAGERS)
(402) 644-7637
Entity
Organization
Contact information
Practice address
2701 W NORFOLK AVE, STE 101, NORFOLK, NE 68701-4408
(402) 644-7262
(402) 644-7227
Mailing address
2701 W NORFOLK AVE, STE 101, NORFOLK, NE 68701-4408
(402) 644-7262
(402) 644-7227
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01307
BCBS
NE
05
—
0719674
—
IA
01
—
490004329
RR MEDICARE
NE
01
—
F885
MIDLANDS CHOICE
NE
Enumeration date
06/21/2005
Last updated
02/24/2020
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