Healthcare Provider Details

I. General information

NPI: 1699879650
Provider Name (Legal Business Name): CLABAUGH PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 COURT ST
BEATRICE NE
68310-3923
US

IV. Provider business mailing address

501 COURT ST
BEATRICE NE
68310-3923
US

V. Phone/Fax

Practice location:
  • Phone: 402-223-3591
  • Fax: 402-228-4842
Mailing address:
  • Phone: 402-223-3591
  • Fax: 402-228-4842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2898
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NATHAN CLABAUGH
Title or Position: OWNER
Credential:
Phone: 402-223-3591