Provider Demographics
NPI:1043436587
Name:ACAMO, THERESE MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THERESE
Middle Name:MARIE
Last Name:ACAMO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 N 203RD ST
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-2885
Mailing Address - Country:US
Mailing Address - Phone:402-590-7808
Mailing Address - Fax:402-289-1153
Practice Address - Street 1:1810 N 203RD ST
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-2885
Practice Address - Country:US
Practice Address - Phone:402-590-7808
Practice Address - Fax:402-289-1153
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist