Provider Demographics
NPI:1336290626
Name:NEBRASKA SURGICAL FACILITY,INC.
Entity Type:Organization
Organization Name:NEBRASKA SURGICAL FACILITY,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:TALBITZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-345-6617
Mailing Address - Street 1:PO BOX 8518
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68108-0518
Mailing Address - Country:US
Mailing Address - Phone:402-345-6617
Mailing Address - Fax:402-345-0309
Practice Address - Street 1:1207 S 13TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68108-3501
Practice Address - Country:US
Practice Address - Phone:402-345-6617
Practice Address - Fax:402-345-0309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical