Healthcare Provider Details

I. General information

NPI: 1679174445
Provider Name (Legal Business Name): CARLA JUDITH CUEVAS PHARM. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2020
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 CENTER ST
OMAHA NE
68106-3122
US

IV. Provider business mailing address

2323 S 8TH ST
OMAHA NE
68108-1122
US

V. Phone/Fax

Practice location:
  • Phone: 402-553-4143
  • Fax: 402-553-7569
Mailing address:
  • Phone: 402-249-1507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10751
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: