| NPI | 1902445414 |
|---|---|
| Doing Business As | PREVENTATIVE MEDICAL CLINIC PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JUSTIN M KOHLL President 402-306-6503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2019-12-31 |
| Last Update Date | 2019-12-31 |