Healthcare Provider Details
I. General information
NPI: 1104969872
Provider Name (Legal Business Name): NO FRILLS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/14/2007
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7646 DODGE ST
OMAHA NE
68114-3635
US
IV. Provider business mailing address
6232 N 104TH ST ATTN MIKE AKSAMIT
OMAHA NE
68134-1012
US
V. Phone/Fax
- Phone: 402-392-0371
- Fax: 402-392-0975
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 2617 |
| License Number State | NE |
VIII. Authorized Official
Name:
MIKE
AKSAMIT
Title or Position: PRESIDENT
Credential: PHARM D RP MBA
Phone: 402-657-1793