Provider Demographics
NPI:1518982479
Name:REDLINE PHARMACY SOLUTIONS, LLC.
Entity Type:Organization
Organization Name:REDLINE PHARMACY SOLUTIONS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:F
Authorized Official - Last Name:REDLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-462-2929
Mailing Address - Street 1:1170 NE INDUSTRIAL PARK RD
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-1100
Mailing Address - Country:US
Mailing Address - Phone:601-482-7420
Mailing Address - Fax:601-482-7490
Practice Address - Street 1:2415 OSBORNE DR E
Practice Address - Street 2:SUITE 100
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-2577
Practice Address - Country:US
Practice Address - Phone:402-462-2929
Practice Address - Fax:402-462-2932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2835332B00000X, 332BP3500X, 333600000X, 3336C0003X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE09929OtherBCBS OF NE
NE09929OtherBCBS OF NE
NE09929OtherBCBS OF NE
4680000001Medicare NSC