| NPI | 1023104999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE TIESI Senior Director Of Pharmacy 402-343-4546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NE 2416) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2017-10-23 |