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General NPI Number Information
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NPI Number | 1538765920
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Entity Type | Organization
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Legal Business Name | KUBAT PHARMACY, LLC
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Dates
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Enumeration Date | 12/10/2020
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 120 N 27TH ST STE 100A
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City | NORFOLK
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State | NE
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Zip | 68701-3286
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Country | US
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Telephone | 402-371-3444
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Fax | 402-371-3566
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Provider Business Mailing Address
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Address Line | 3206 S 71ST ST
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City | OMAHA
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State | NE
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Zip | 68106-3507
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Country | US
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Telephone | 402-558-1192
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Fax | 402-558-0135
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Authorized Official
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Title or Position | EVP MEDICAL OPERATIONS
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Name | MR. BRIAN PAUL DANIEL
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Credential |
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Telephone | 402-301-1307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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