Provider Demographics
NPI:1205831237
Name:CARL T CURTIS HEALTH CENTER PHARMACY
Entity Type:Organization
Organization Name:CARL T CURTIS HEALTH CENTER PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-837-5381
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:MACY
Mailing Address - State:NE
Mailing Address - Zip Code:68039-0250
Mailing Address - Country:US
Mailing Address - Phone:402-837-5381
Mailing Address - Fax:402-837-4358
Practice Address - Street 1:100 INDIAN HILL DR
Practice Address - Street 2:
Practice Address - City:MACY
Practice Address - State:NE
Practice Address - Zip Code:68039-3023
Practice Address - Country:US
Practice Address - Phone:402-837-5381
Practice Address - Fax:402-837-4358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1522261QF0400X, 332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========01Medicaid
NE4178860001Medicare NSC
NE=========01Medicaid