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General NPI Number Information
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NPI Number | 1144042524
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Entity Type | Organization
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Legal Business Name | AINSWORTH PHARMACY
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 255 N MAIN ST
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City | AINSWORTH
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State | NE
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Zip | 69210-1300
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Country | US
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Telephone | 402-387-1403
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Fax |
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Provider Business Mailing Address
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Address Line | 945 E ZERO ST.
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City | AINSWORTH
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State | NE
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Zip | 69210
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Country | US
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Telephone | 402-387-2800
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MIRYA HALLOCK
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Credential |
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Telephone | 402-387-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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