| NPI | 1518504802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY GENE HINES Owner 402-202-7631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 183500000X Pharmacist |
| Enumeration Date | 2019-12-05 |
| Last Update Date | 2019-12-05 |