Provider Demographics
NPI:1295973006
Name:ST. MARY'S OUTPATIENT SURGERY CENTER AT GALENA LLC
Entity type:Organization
Organization Name:ST. MARY'S OUTPATIENT SURGERY CENTER AT GALENA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:775-674-5200
Mailing Address - Street 1:18653 WEDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-3005
Mailing Address - Country:US
Mailing Address - Phone:775-674-5200
Mailing Address - Fax:775-657-8043
Practice Address - Street 1:18653 WEDGE PKWY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-3005
Practice Address - Country:US
Practice Address - Phone:775-674-5200
Practice Address - Fax:775-674-5228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-02
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical