Healthcare Provider Details

I. General information

NPI: 1023993375
Provider Name (Legal Business Name): TREY AUSTIN ROSENAU RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4840 DODGE ST
OMAHA NE
68132-3111
US

IV. Provider business mailing address

409 HIGHWAY 281 NE
CARRINGTON ND
58421-8795
US

V. Phone/Fax

Practice location:
  • Phone: 402-558-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18672
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH6671
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: