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NPI Code Detail

MEDICARE: LINDA CARMELA MYERS-BOCK R.P.

MEDICARE: LINDA CARMELA MYERS-BOCK R.P.
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
1183500000XPharmacist10519NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110519OTHERNEPHARMACY LISCENSE NUMBER

General Provider Information

NPI Number : 1548388275
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA CARMELA MYERS-BOCK R.P.
Provider Business Mailing Address
First Line : 3554 25TH AVE.
Second Line :
City : COLUMBUS
State : NE
Zip : 68601
Country : US
Telephone Number : 402-562-7668
Fax Number : 402-563-0915
Provider Business Practice Location Address
First Line : 3010 23RD ST
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-3122
Country : US
Telephone Number : 402-562-7668
Fax Number : 402-563-0915
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 07/08/2007

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