Healthcare Provider Details

I. General information

NPI: 1770695777
Provider Name (Legal Business Name): EPE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 N MAIN ST
WEST POINT NE
68788-1416
US

IV. Provider business mailing address

124 N MAIN ST
WEST POINT NE
68788-1416
US

V. Phone/Fax

Practice location:
  • Phone: 402-372-2108
  • Fax: 402-372-2425
Mailing address:
  • Phone: 402-372-2108
  • Fax: 402-372-2425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2183
License Number StateNE

VIII. Authorized Official

Name: JON EINFALT
Title or Position: PRESIDENT
Credential: PHARM.D.
Phone: 402-372-2108