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General NPI Number Information
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NPI Number | 1528127446
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Entity Type | Organization
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Legal Business Name | MILTONJ,INC
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2145 S 17TH ST
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City | LINCOLN
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State | NE
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Zip | 68502-3711
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Country | US
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Telephone | 402-435-1090
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Fax | 402-435-1350
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Provider Business Mailing Address
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Address Line | 2145 S 17TH ST
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City | LINCOLN
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State | NE
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Zip | 68502-3711
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Country | US
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Telephone | 402-435-1090
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Fax | 402-435-1350
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMES WELTY JOHNSON
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Credential | R.P.
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Telephone | 402-435-1090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 2354
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License Number State | NE
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