Healthcare Provider Details

I. General information

NPI: 1043322043
Provider Name (Legal Business Name): TML4LIFE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 COURT ST
BEATRICE NE
68310-3960
US

IV. Provider business mailing address

601 COURT ST
BEATRICE NE
68310-3960
US

V. Phone/Fax

Practice location:
  • Phone: 402-223-2379
  • Fax: 402-223-2370
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2714
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TOD LUNDBERG
Title or Position: OWNER AND PHARMACIST
Credential: PHARM D
Phone: 402-223-2379