MEDICARE: ANTON ANDERSON PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	14555	NE

General Provider Information

NPI Number	:	1073149688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTON ANDERSON PHARMD

Provider Business Mailing Address
First Line	:	1301 W NORFOLK AVE
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68701-4833
Country	:	US
Telephone Number	:	402-371-9438
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 W NORFOLK AVE
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68701-4833
Country	:	US
Telephone Number	:	402-371-9438
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2020
Last Update Date	:	03/14/2020

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Directions to “ ANTON ANDERSON PHARMD” Practice Location

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