Provider Demographics
NPI:1326107509
Name:OMAHA AMBULATORY SURGERY CENTER LLC
Entity Type:Organization
Organization Name:OMAHA AMBULATORY SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIONNE
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:FINKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-391-7246
Mailing Address - Street 1:825 N 90TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2706
Mailing Address - Country:US
Mailing Address - Phone:402-391-7246
Mailing Address - Fax:402-408-1783
Practice Address - Street 1:825 N 90TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2702
Practice Address - Country:US
Practice Address - Phone:402-391-7246
Practice Address - Fax:402-408-1783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NENA10540Medicaid