Provider Demographics
NPI:1497208755
Name:NORTH PLATTE PHARMACY INC
Entity Type:Organization
Organization Name:NORTH PLATTE PHARMACY INC
Other - Org Name:U-SAVE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:COVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-221-6993
Mailing Address - Street 1:211 W LEOTA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6103
Mailing Address - Country:US
Mailing Address - Phone:308-532-0310
Mailing Address - Fax:308-532-2781
Practice Address - Street 1:211 W LEOTA ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6103
Practice Address - Country:US
Practice Address - Phone:308-532-0310
Practice Address - Fax:308-532-2781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-03
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NE28283336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2162377OtherPK
NE10026653400Medicaid