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General NPI Number Information
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NPI Number | 1760785042
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Entity Type | Organization
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Legal Business Name | SHERDA ENTERPRISES LLC
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Dates
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Enumeration Date | 12/08/2010
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Last Update Date | 07/16/2013
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Provider Practice Location Address
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Address Line | 1312 Q ST
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City | FRANKLIN
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State | NE
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Zip | 68939-1071
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Country | US
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Telephone | 308-425-3319
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Fax | 308-425-3602
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Provider Business Mailing Address
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Address Line | 1312 Q ST
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City | FRANKLIN
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State | NE
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Zip | 68939-1071
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Country | US
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Telephone | 308-425-3319
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Fax | 308-425-3602
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Authorized Official
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Title or Position | OWNER
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Name | DAVE LIESKE
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Credential |
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Telephone | 308-425-3319
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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 | 2894
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License Number State | NE
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