Provider Demographics
NPI:1497388649
Name:GROUP DPC, LLC
Entity Type:Organization
Organization Name:GROUP DPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:THURSTON
Authorized Official - Last Name:TOMLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-614-6363
Mailing Address - Street 1:2206 LONGO DR STE 209
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-2977
Mailing Address - Country:US
Mailing Address - Phone:402-509-7474
Mailing Address - Fax:402-509-6969
Practice Address - Street 1:2206 LONGO DR STE 209
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-2977
Practice Address - Country:US
Practice Address - Phone:402-509-7474
Practice Address - Fax:402-509-6969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy