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General NPI Number Information
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NPI Number | 1871942896
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Entity Type | Organization
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Legal Business Name | PENDER CARE CENTRE DISTRICT INC
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 118 18TH ST
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City | WISNER
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State | NE
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Zip | 68791-2237
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Country | US
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Telephone | 402-529-3550
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100
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City | PENDER
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State | NE
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Zip | 68047-0100
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Country | US
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Telephone | 402-385-3350
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Fax | 402-385-0155
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Authorized Official
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Title or Position | CEO
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Name | LAURA J GAMBLE
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Credential |
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Telephone | 402-385-3083
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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 |
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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 | 672
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License Number State | NE
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