MEDICARE: B&R STORES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy		NE

General Provider Information

NPI Number	:	1073906525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B&R STORES, INC

Provider Business Mailing Address
First Line	:	1602 W 2ND ST
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68801-5766
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1602 W 2ND ST
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68801-5766
Country	:	US
Telephone Number	:	308-382-6822
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACY
Name	:	ANTHONY SCHMID
Credential	:	PHARMD
Telephone Number	:	402-464-6297

Provider Enumeration Date	:	03/09/2015
Last Update Date	:	03/09/2015

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Directions to “B&R STORES, INC ” Practice Location

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