| NPI | 1063089050 |
|---|---|
| Doing Business As | MEDICINE MAN PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JED LEWIS Vice President 402-652-3217 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2021-06-08 |