Healthcare Provider Details

I. General information

NPI: 1346840196
Provider Name (Legal Business Name): LISA CAHA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2020
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13851 GUILDFORD ST STE D
WAVERLY NE
68462-1453
US

IV. Provider business mailing address

13851 GUILDFORD ST STE D
WAVERLY NE
68462-1453
US

V. Phone/Fax

Practice location:
  • Phone: 402-786-0225
  • Fax: 402-786-2155
Mailing address:
  • Phone: 402-786-0225
  • Fax: 402-786-2155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11746
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: