Provider Demographics
NPI:1215205166
Name:ZWEEDYK, MARC (RP)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:ZWEEDYK
Suffix:
Gender:M
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8380 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-2918
Mailing Address - Country:US
Mailing Address - Phone:402-592-7990
Mailing Address - Fax:402-592-7377
Practice Address - Street 1:8380 HARRISON ST
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-2918
Practice Address - Country:US
Practice Address - Phone:402-592-7990
Practice Address - Fax:402-592-7377
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11852183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist