Healthcare Provider Details

I. General information

NPI: 1598800450
Provider Name (Legal Business Name): WESTERN DRUG CO. OF CHAPPELL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 01/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 2ND ST.
CHAPPELL NE
69129
US

IV. Provider business mailing address

650 2ND ST. P.O. BOX 368
CHAPPELL NE
69129
US

V. Phone/Fax

Practice location:
  • Phone: 308-874-2200
  • Fax: 308-874-3379
Mailing address:
  • Phone: 308-874-2200
  • Fax: 308-874-3379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2154
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE LEE SCHMID
Title or Position: OWNER
Credential: R.PH
Phone: 308-874-2200