Provider Demographics
NPI:1427199843
Name:TPK CORPORATION
Entity Type:Organization
Organization Name:TPK CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BRENNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-245-2400
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:1602 1/2 STONE STREET
Mailing Address - City:FALLS CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68355
Mailing Address - Country:US
Mailing Address - Phone:402-245-2400
Mailing Address - Fax:402-245-4846
Practice Address - Street 1:1602 & ONE HALF STONE STREET
Practice Address - Street 2:
Practice Address - City:FALLS CITY
Practice Address - State:NE
Practice Address - Zip Code:68355
Practice Address - Country:US
Practice Address - Phone:402-245-2400
Practice Address - Fax:402-245-4846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1453336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0416470001Medicare NSC