Healthcare Provider Details

I. General information

NPI: 1073524153
Provider Name (Legal Business Name): RUFFNER PHARMACY, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 CHICAGO AVE
PLATTSMOUTH NE
68048-2059
US

IV. Provider business mailing address

506 CHICAGO AVE
PLATTSMOUTH NE
68048-2059
US

V. Phone/Fax

Practice location:
  • Phone: 402-296-6900
  • Fax: 402-296-6990
Mailing address:
  • Phone: 402-296-6900
  • Fax: 402-296-6990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11244
License Number StateNE

VIII. Authorized Official

Name: TROY ALLAN RUFFNER
Title or Position: OWNER/PHARMACY MANAGER
Credential: PHARM. D.
Phone: 402-296-6900