Healthcare Provider Details

I. General information

NPI: 1083797005
Provider Name (Legal Business Name): VOGT PHARMACIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 06/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 N LINDEN ST
WAHOO NE
68066-1961
US

IV. Provider business mailing address

526 N LINDEN ST
WAHOO NE
68066-1961
US

V. Phone/Fax

Practice location:
  • Phone: 402-443-4167
  • Fax: 402-443-4168
Mailing address:
  • Phone: 402-443-4167
  • Fax: 402-443-4168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number2535
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MARK VOGT
Title or Position: PRESIDENT
Credential:
Phone: 402-509-8777