Provider Demographics
NPI:1356729636
Name:R CHOICE SURGICAL CENTER LLC
Entity type:Organization
Organization Name:R CHOICE SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOUBRATA
Authorized Official - Middle Name:V
Authorized Official - Last Name:RAIKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-981-4768
Mailing Address - Street 1:2900 ELK LN
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-8691
Mailing Address - Country:US
Mailing Address - Phone:402-721-8895
Mailing Address - Fax:402-721-6663
Practice Address - Street 1:2900 ELK LN
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2433
Practice Address - Country:US
Practice Address - Phone:402-721-8895
Practice Address - Fax:402-721-6663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-07
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical