| NPI | 1275525537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GEOFFREY KOHLL President/Owner 402-895-6812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NE 2239) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: NE 2239) |
| 333600000X Pharmacy (Licence: NE 2239) | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: NE 2239) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2017-10-24 |