Healthcare Provider Details

I. General information

NPI: 1639092943
Provider Name (Legal Business Name): ISAAC HUEFTLE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

989200 NEBRASKA MEDICAL CTR
OMAHA NE
68198-9200
US

IV. Provider business mailing address

989200 NEBRASKA MEDICAL CTR
OMAHA NE
68198-9200
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-5215
  • Fax: 402-559-7150
Mailing address:
  • Phone: 402-559-5215
  • Fax: 402-559-7150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18620
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: