Healthcare Provider Details

I. General information

NPI: 1417229345
Provider Name (Legal Business Name): DALAL A GUMEEL PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 SOUTH ST
LINCOLN NE
68502-2734
US

IV. Provider business mailing address

1701 SOUTH
LINCOLN NE
68502
US

V. Phone/Fax

Practice location:
  • Phone: 402-435-2135
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13772
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: