Provider Demographics
NPI:1427591866
Name:HEALING GIFT FREE CLINIC
Entity Type:Organization
Organization Name:HEALING GIFT FREE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:CAMENZIND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:402-651-0561
Mailing Address - Street 1:2650 FARNAM ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-3616
Mailing Address - Country:US
Mailing Address - Phone:402-341-7761
Mailing Address - Fax:
Practice Address - Street 1:2650 FARNAM ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-3616
Practice Address - Country:US
Practice Address - Phone:402-341-7761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KOUNTZE MEMORIAL LUTHERAN CHURCH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE29943336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy