Healthcare Provider Details

I. General information

NPI: 1093107286
Provider Name (Legal Business Name): ALLYN KOMOROWSKI PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 02/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 26TH ST
CENTRAL CITY NE
68826-9501
US

IV. Provider business mailing address

902 14TH ST
CENTRAL CITY NE
68826-1553
US

V. Phone/Fax

Practice location:
  • Phone: 308-946-3015
  • Fax:
Mailing address:
  • Phone: 308-624-0428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14548
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: