| NPI | 1447383948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA GROTHE Pharmacy Director 402-930-4206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251F00000X Home Infusion (Licence: NE 2146) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: NE 2820) |
| 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NE 2820) | |
| 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: IA 3100) | |
| 3336H0001X Pharmacy Home Infusion Therapy Pharmacy | |
| 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: NE 2820) | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: NE 2820) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2023-03-14 |