Provider Demographics
NPI:1780869222
Name:NORTH PLATTE SURGERY CENTER ANESTHESIA, LLC
Entity type:Organization
Organization Name:NORTH PLATTE SURGERY CENTER ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF THE BOARD
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:N
Authorized Official - Last Name:SHRECK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-534-8800
Mailing Address - Street 1:621 W FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-0608
Mailing Address - Country:US
Mailing Address - Phone:308-534-8800
Mailing Address - Fax:308-534-2008
Practice Address - Street 1:621 W FRANCIS ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-0608
Practice Address - Country:US
Practice Address - Phone:308-534-8800
Practice Address - Fax:308-534-2008
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH PLATTE SURGERY CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-03
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty