Provider Demographics
NPI:1588913180
Name:NEBRASKA SURGICAL ANESTHESIA SERVICES LLC
Entity type:Organization
Organization Name:NEBRASKA SURGICAL ANESTHESIA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:R
Authorized Official - Last Name:RIBAUDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-446-1417
Mailing Address - Street 1:PO BOX 935566
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-5566
Mailing Address - Country:US
Mailing Address - Phone:636-938-6868
Mailing Address - Fax:
Practice Address - Street 1:11819 MIRACLE HILLS DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-5308
Practice Address - Country:US
Practice Address - Phone:800-835-9102
Practice Address - Fax:706-650-1034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty