Healthcare Provider Details

I. General information

NPI: 1619622362
Provider Name (Legal Business Name): KUBAT PHARMACY ASHLAND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2022
Last Update Date: 02/21/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 SILVER ST
ASHLAND NE
68003-1845
US

IV. Provider business mailing address

1401 SILVER ST
ASHLAND NE
68003-1845
US

V. Phone/Fax

Practice location:
  • Phone: 402-944-3303
  • Fax: 402-944-9413
Mailing address:
  • Phone: 402-944-3303
  • Fax: 402-944-9413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY SCHMID
Title or Position: VP PHARMACY OPERATIONS
Credential:
Phone: 531-233-4455