Provider Demographics
NPI:1346315249
Name:LASSEN, ROBERT L (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:LASSEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5131 QUAIL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-1852
Mailing Address - Country:US
Mailing Address - Phone:402-420-2680
Mailing Address - Fax:402-489-8676
Practice Address - Street 1:5131 QUAIL RIDGE DRIVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516
Practice Address - Country:US
Practice Address - Phone:402-420-2680
Practice Address - Fax:402-489-8676
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE81041835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric