| Organization Name: | GREAT BASIN SURGICAL CENTER, LLC |
| NPI Number: | 1114984549 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSANNE CROSS (OFFICE MANAGER) |
| Mailing Address: | 855 Golfcourse Rd Elko |
| State: | NV US |
| Postal Code: | 898013451 |
| Phone Number: | 7757534700 |
| Fax Number: | 7757534703 |
| NPI Enumeration Date: | 04/28/2006 |
| NPI Last Update Date: | 03/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 2172ASC-8 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |