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NPI Code Detail

MEDICARE: MARY K THOMSEN R.P.

MEDICARE: MARY K THOMSEN 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
1183500000XPharmacist8078NE
2183500000XPharmacist13808IA

General Provider Information

NPI Number : 1912274010
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY K THOMSEN R.P.
Provider Business Mailing Address
First Line : 5111 HAMILTON ST
Second Line :
City : OMAHA
State : NE
Zip : 68132-1449
Country : US
Telephone Number : 402-558-6065
Fax Number :
Provider Business Practice Location Address
First Line : 7151 CASS ST
Second Line :
City : OMAHA
State : NE
Zip : 68132-2652
Country : US
Telephone Number : 402-558-6065
Fax Number : 402-558-8770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2011
Last Update Date : 11/17/2011

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