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1134739733
CHARLES WAYNE JACKSON
OMAHA, NE
NPI
1134739733
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: NE 16860)
Enumeration Date
2020-08-07
Last Update Date
2020-08-07
Business Address
CHARLES WAYNE JACKSON pharmacist
2451 N 90TH ST
OMAHA, NE 68134-6009
Phone number: 402-609-5275
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Mailing Address
CHARLES WAYNE JACKSON pharmacist
2451 N 90TH ST
OMAHA, NE 68134-6009
Phone number: 402-609-5275
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