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NPI Code Detail

MEDICARE: MITCHELL DRUG

MEDICARE: MITCHELL DRUG
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
13336C0003XCommunity/Retail Pharmacy534NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12141199OTHERPK

General Provider Information

NPI Number : 1235570714
Entity Type Code : Organization
Provider Name (Legal Business Name) : MITCHELL DRUG
Provider Business Mailing Address
First Line : PO BOX 98
Second Line :
City : MITCHELL
State : NE
Zip : 69357-0098
Country : US
Telephone Number : 308-623-2400
Fax Number : 308-623-2408
Provider Business Practice Location Address
First Line : 1456 CENTER AVE
Second Line :
City : MITCHELL
State : NE
Zip : 69357-1448
Country : US
Telephone Number : 308-623-2400
Fax Number : 308-623-2408
Authorized Official
Title or Position : PRESIDENT
Name : ROBERT BAILEY
Credential :
Telephone Number : 308-623-2400
Provider Enumeration Date : 07/11/2013
Last Update Date : 08/20/2013

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Practice Location Address:
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1700931326 — DR. RYAN N BOWLIN D.C.
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1689712952 — CITY OF MITCHELL
Practice Location Address:
1723 23RD ST
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69357
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1841330966 — WESTERN TRAILS CHIROPRACTIC LLC
Practice Location Address:
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1760647879 — JANET MARIAN SHAULIS RN,BSN
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Directions to “MITCHELL DRUG ” Practice Location

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