| 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 |