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NPI Code Detail

MEDICARE: MR. GREGORY KYLE HUGGLER RP

MEDICARE: MR. GREGORY KYLE HUGGLER RP
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
1183500000XPharmacist10811NE

General Provider Information

NPI Number : 1821087867
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GREGORY KYLE HUGGLER RP
Provider Business Mailing Address
First Line : 1355 S 157TH CT
Second Line :
City : OMAHA
State : NE
Zip : 68130-2594
Country : US
Telephone Number : 402-934-4187
Fax Number :
Provider Business Practice Location Address
First Line : 11134 Q ST
Second Line :
City : OMAHA
State : NE
Zip : 68137-3609
Country : US
Telephone Number : 402-592-5244
Fax Number : 402-592-2501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 07/08/2007

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