1821247552 NPI number — U-SAVE PHARMACY INC

Table of content: (NPI 1821247552)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821247552 NPI number — U-SAVE PHARMACY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
U-SAVE PHARMACY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
U SAVE PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821247552
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 968
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELKHORN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68022-0968
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-289-2576
Provider Business Mailing Address Fax Number:
402-289-2540

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
940 N 204TH AVE
Provider Second Line Business Practice Location Address:
STE 270
Provider Business Practice Location Address City Name:
ELKHORN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68022-4606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-289-2576
Provider Business Practice Location Address Fax Number:
402-289-2540
Provider Enumeration Date:
09/18/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LONGCOR
Authorized Official First Name:
LYNN
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACY MANAGER
Authorized Official Telephone Number:
402-289-2576

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  2815 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2817712 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".