| NPI | 1104992866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLBY HAYNES Vice President 402-335-3375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: IA 371) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2019-10-18 |