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	3336C0003X	Community/Retail Pharmacy	2413	NE

General Provider Information

NPI Number	:	1184731499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B & R STORES, INC

Provider Business Mailing Address
First Line	:	2525 PINE LAKE RD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68512-3632
Country	:	US
Telephone Number	:	402-420-8268
Fax Number	:	402-434-5784

Provider Business Practice Location Address
First Line	:	2525 PINE LAKE RD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68512-3632
Country	:	US
Telephone Number	:	402-420-8268
Fax Number	:	402-434-5784

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	11/09/2012

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

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