| NPI | 1295828119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE COMSTOCK Owner 402-426-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NE 8054) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NE 8054) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-11-08 |