Provider Demographics
NPI:1396022661
Name:PERKINS, GUY ANTHONY (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:GUY
Middle Name:ANTHONY
Last Name:PERKINS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 S 9TH ST APT 615
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-1158
Mailing Address - Country:US
Mailing Address - Phone:402-202-7742
Mailing Address - Fax:
Practice Address - Street 1:7202 N 30TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68112-2819
Practice Address - Country:US
Practice Address - Phone:402-457-5615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13655183500000X
IA21473183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist