| NPI | 1164414413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID G KOHLL Owner 402-895-6812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: 2317) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2022-07-21 |