NPI | 1508321027 |
---|---|
Doing Business As | MEDICINE MAN PHARMACY |
Entity Type | Organization |
Authorized Contact | JED LEWIS Vice President Secretary 402-652-3217 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
3336M0002X Pharmacy, Mail Order Pharmacy | |
3336S0011X Pharmacy, Specialty Pharmacy | |
Enumeration Date | 2019-02-08 |
Last Update Date | 2021-06-08 |