Provider Demographics
NPI:1417977331
Name:NAGENGAST PHARMACIES, INC
Entity Type:Organization
Organization Name:NAGENGAST PHARMACIES, INC
Other - Org Name:VERDIGRE PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:NAGENGAST
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:402-373-4411
Mailing Address - Street 1:403 JAMES ST
Mailing Address - Street 2:BOX 23
Mailing Address - City:VERDIGRE
Mailing Address - State:NE
Mailing Address - Zip Code:68783-6149
Mailing Address - Country:US
Mailing Address - Phone:402-668-2218
Mailing Address - Fax:
Practice Address - Street 1:403 JAMES ST
Practice Address - Street 2:
Practice Address - City:VERDIGRE
Practice Address - State:NE
Practice Address - Zip Code:68783-6149
Practice Address - Country:US
Practice Address - Phone:402-668-2218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE24293336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2812053OtherNCPDP
NE2812053OtherNCPDP