Healthcare Provider Details

I. General information

NPI: 1720854722
Provider Name (Legal Business Name): KUBAT PHARMACY BEATRICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2023
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 COURT ST
BEATRICE NE
68310-4085
US

IV. Provider business mailing address

910 COURT ST
BEATRICE NE
68310-4085
US

V. Phone/Fax

Practice location:
  • Phone: 402-223-4779
  • Fax:
Mailing address:
  • Phone: 402-223-4779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY SCHMID
Title or Position: VP PHARMACY
Credential: PHARMD
Phone: 531-710-4441