Provider Demographics
NPI:1881858918
Name:BERGAN MERCY SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:BERGAN MERCY SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:VOIGT
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:402-398-6126
Mailing Address - Street 1:7500 MERCY ROAD
Mailing Address - Street 2:SUITE 4300
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2319
Mailing Address - Country:US
Mailing Address - Phone:402-398-5665
Mailing Address - Fax:402-398-6606
Practice Address - Street 1:7500 MERCY ROAD
Practice Address - Street 2:SUITE 4300
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2319
Practice Address - Country:US
Practice Address - Phone:402-398-5665
Practice Address - Fax:402-398-6606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA1903X
NEASC064261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical