Provider Demographics
NPI:1477885697
Name:BARMORE DRUG STORES INC
Entity Type:Organization
Organization Name:BARMORE DRUG STORES INC
Other - Org Name:PLUM CREEK LONG TERM CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BARMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-324-6011
Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850-0500
Mailing Address - Country:US
Mailing Address - Phone:308-324-4611
Mailing Address - Fax:308-324-7150
Practice Address - Street 1:109 E 6TH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850-1905
Practice Address - Country:US
Practice Address - Phone:308-324-6011
Practice Address - Fax:308-324-3342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-14
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE28693336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2124657OtherPK
NE=========00Medicaid