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General NPI Number Information
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NPI Number | 1255345518
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Entity Type | Organization
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Legal Business Name | PHARMACY EXPRESS SERVICES INC.
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1801 VALLEY VIEW DR
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-5462
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Country | US
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Telephone | 712-322-6448
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 241148
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City | OMAHA
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State | NE
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Zip | 68124-5148
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Country | US
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Telephone | 712-322-6448
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRUCE S GOLDBERG
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Credential |
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Telephone | 712-322-6448
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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 | 1007
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License Number State | IA
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