Provider Demographics
NPI:1477264596
Name:THE NEBRASKA MEDICAL CENTER
Entity Type:Organization
Organization Name:THE NEBRASKA MEDICAL CENTER
Other - Org Name:NEBRASKA MEDICINE VILLAGE POINTE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY OPERATIONS ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CAVANAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-552-3927
Mailing Address - Street 1:770 N 114TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-1572
Mailing Address - Country:US
Mailing Address - Phone:402-552-3927
Mailing Address - Fax:402-559-4700
Practice Address - Street 1:17405 BURKE ST.
Practice Address - Street 2:SUITE 0026
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118
Practice Address - Country:US
Practice Address - Phone:402-552-3927
Practice Address - Fax:402-559-4700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEBRASKA MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-09
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy