Healthcare Provider Details

I. General information

NPI: 1992836357
Provider Name (Legal Business Name): REIMER PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 06/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 BROADWAY ST
FULLERTON NE
68638-3152
US

IV. Provider business mailing address

PO BOX 460
FULLERTON NE
68638-0460
US

V. Phone/Fax

Practice location:
  • Phone: 308-536-2641
  • Fax: 308-536-2680
Mailing address:
  • Phone: 308-536-2641
  • Fax: 308-536-2680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number3041
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NIKOLAS REIMER
Title or Position: OWNER
Credential:
Phone: 308-536-2641