| NPI | 1295161578 |
|---|---|
| Doing Business As | IDA DRUG |
| Entity Type | Organization |
| Authorized Contact | MARK VOGT President 402-509-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IA 1478) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2015-05-04 |