Healthcare Provider Details

I. General information

NPI: 1629098835
Provider Name (Legal Business Name): NAGENGAST PHARMACIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 05/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S BROADWAY ST STE 1
BLOOMFIELD NE
68718-4419
US

IV. Provider business mailing address

PO BOX 9
BLOOMFIELD NE
68718-0009
US

V. Phone/Fax

Practice location:
  • Phone: 402-373-4411
  • Fax: 402-373-4719
Mailing address:
  • Phone: 402-373-4411
  • Fax: 402-373-4719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2865
License Number StateNE

VIII. Authorized Official

Name: ANDREA ABBENHAUS
Title or Position: CPHT, AO
Credential:
Phone: 402-373-4411