Provider Demographics
NPI:1568936136
Name:CW INC
Entity Type:Organization
Organization Name:CW INC
Other - Org Name:WANEK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-887-5426
Mailing Address - Street 1:410 M ST
Mailing Address - Street 2:
Mailing Address - City:NELIGH
Mailing Address - State:NE
Mailing Address - Zip Code:68756-1423
Mailing Address - Country:US
Mailing Address - Phone:402-887-5426
Mailing Address - Fax:
Practice Address - Street 1:410 M ST
Practice Address - Street 2:
Practice Address - City:NELIGH
Practice Address - State:NE
Practice Address - Zip Code:68756-1423
Practice Address - Country:US
Practice Address - Phone:402-887-5426
Practice Address - Fax:402-887-4595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-17
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025740700Medicaid