| NPI | 1528281961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL HENDERSON MCGINNIS Pharmacist In Charge 308-784-2238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NE 1268) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NE 1268) |
| 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: NE 1268) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2015-03-24 |