| NPI | 1528344280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVE DYER Pharmacy Manager 402-362-1280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NE 1346431285) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2011-10-26 |