MEDICARE: EXTENDCARE THE PHARMACY 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	2978	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2055930	OTHER		PK

General Provider Information

NPI Number	:	1538348842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXTENDCARE THE PHARMACY INC

Provider Business Mailing Address
First Line	:	1219 N COTNER BLVD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68505-1837
Country	:	US
Telephone Number	:	402-466-6083
Fax Number	:	402-466-6086

Provider Business Practice Location Address
First Line	:	1219 N COTNER BLVD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68505-1837
Country	:	US
Telephone Number	:	402-466-6083
Fax Number	:	402-466-6086

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEVAN OSENBAUGH
Credential	:
Telephone Number	:	402-466-7283

Provider Enumeration Date	:	11/02/2007
Last Update Date	:	10/19/2016

Similar Medicare Providers

1144218371 — DONNA M. HOWE DDS
Practice Location Address:

1217 N COTNER BLVD
LINCOLN, NE
68505-1837

Practice Phone: 402-466-9632
Practice Fax:

1578662797 — DR. CATHERINE DIANE SEAGREN ALLEY DDS MS
Practice Location Address:

1217 NORTH COTNER BLVD
LINCOLN, NE
68505-1837

Practice Phone: 402-466-6700
Practice Fax: 402-466-6700

1891900502 — DR. PAUL A HANSEN DDS
Practice Location Address:

1217 N COTNER BLVD
LINCOLN, NE
68505-1837

Practice Phone: 402-466-9632
Practice Fax:

1457627671 — MELISSA CHICHELO
Practice Location Address:

351 GETTYSBURG WAY
LINCOLN PARK, NJ
07035-1837

Practice Phone: 973-768-3169
Practice Fax:

1447598347 — PTM TRANSPORTATION, LLC
Practice Location Address:

800 LINCOLN AVE
MARMORA, NJ
08223-1837

Practice Phone: 609-573-2226
Practice Fax: 609-478-6388

1891644167 — KHAOSARA REMILEKUN AKINTOYE
Practice Location Address:

420 S 18TH ST APT 249
LINCOLN, NE
68508-1837

Practice Phone: 402-580-3208
Practice Fax:

Directions to “EXTENDCARE THE PHARMACY INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.