MEDICARE: FALLS CITY MEDS INC

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	333600000X	Pharmacy
2	3336L0003X	Long Term Care Pharmacy
3	3336C0003X	Community/Retail Pharmacy	2939	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	2136754	OTHER	PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265432561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FALLS CITY MEDS INC

Provider Business Mailing Address
First Line	:	120 E 18TH ST
Second Line	:
City	:	FALLS CITY
State	:	NE
Zip	:	68355-2116
Country	:	US
Telephone Number	:	402-245-2029
Fax Number	:	402-245-2521

Provider Business Practice Location Address
First Line	:	120 E 18TH ST
Second Line	:
City	:	FALLS CITY
State	:	NE
Zip	:	68355-2116
Country	:	US
Telephone Number	:	402-245-2029
Fax Number	:	402-245-2521

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SRINIVASA RAJU VEGESANA
Credential	:
Telephone Number	:	407-687-3393

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	12/06/2013

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Directions to “FALLS CITY MEDS INC ” Practice Location

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