| NPI | 1407069297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY LOBEDA Owner 308-398-0538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: NE 2817) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2021-02-01 |