Provider Demographics
NPI:1558328997
Name:OSIE INC.
Entity Type:Organization
Organization Name:OSIE INC.
Other - Org Name:THE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVAN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:OSENBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:RP
Authorized Official - Phone:402-466-7283
Mailing Address - Street 1:1221 N COTNER BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-1879
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1221 N COTNER BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-1879
Practice Address - Country:US
Practice Address - Phone:402-466-7283
Practice Address - Fax:402-466-5387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE25903336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Not Answered3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE=========00Medicaid