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General NPI Number Information
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NPI Number | 1780135319
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Entity Type | Organization
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Legal Business Name | NEBRASKA MEDICAL CENTER
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Dates
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Enumeration Date | 10/19/2016
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Last Update Date | 12/17/2019
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Provider Practice Location Address
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Address Line | 4014 LEAVENWORTH STREET
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City | OMAHA
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State | NE
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Zip | 68198-5610
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Country | US
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Telephone | 402-552-7999
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Fax | 402-552-7792
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Provider Business Mailing Address
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Address Line | 4014 LEAVENWORTH STREET
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City | OMAHA
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State | NE
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Zip | 68105
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Country | US
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Telephone | 402-552-3927
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Fax | 402-559-5597
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | APRIL M. DAVIDSON
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Credential | RPH
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Telephone | 402-559-3287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 3114
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License Number State | NE
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