| NPI | 1285044032 |
|---|---|
| Doing Business As | MEDICINE MAN PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MITCH STAIGER Vice President/Pharmacist In Charge 402-652-3217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NE 3034) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2019-12-26 |