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General NPI Number Information
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NPI Number | 1285739136
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Entity Type | Organization
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Legal Business Name | RICHARD D. MULDER
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 12/12/2012
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Provider Practice Location Address
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Address Line | 301 N OAKLAND AVE
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City | OAKLAND
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State | NE
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Zip | 68045-1132
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Country | US
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Telephone | 402-685-5883
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Fax | 402-685-5173
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Provider Business Mailing Address
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Address Line | 301 N OAKLAND AVE
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City | OAKLAND
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State | NE
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Zip | 68045-1132
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Country | US
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Telephone | 402-685-5883
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Fax | 402-685-5173
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICHARD DEAN MULDER
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Credential | RPH
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Telephone | 402-685-5883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10882
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License Number State | NE
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