| NPI | 1811331762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CRUM Pharmacy Manager 308-762-1258 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NE 3336c0003x) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2013-04-23 |