Healthcare Provider Details

I. General information

NPI: 1033056916
Provider Name (Legal Business Name): RYAN LLOYD BAER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 DODGE ST
OMAHA NE
68131-2627
US

IV. Provider business mailing address

15614 REDWOOD ST
OMAHA NE
68136-3170
US

V. Phone/Fax

Practice location:
  • Phone: 402-342-3301
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18971
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: