=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790701068
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HILLTOP ENTERPRISES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2006
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2115 14TH ST STE 201
-----------------------------------------------------
City | AUBURN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68305-1760
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-274-5225
-----------------------------------------------------
Fax | 402-274-5229
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2115 14TH ST STE 201
-----------------------------------------------------
City | AUBURN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-274-5225
-----------------------------------------------------
Fax | 402-274-5229
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. GARY GNSZ
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 402-274-4993
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 2577
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------