Provider Demographics
NPI:1578509956
Name:AH PHARMACY SERVICES LLC
Entity Type:Organization
Organization Name:AH PHARMACY SERVICES LLC
Other - Org Name:AH PHARMACY SERVICES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:STUMPFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-677-1596
Mailing Address - Street 1:10077 S 134TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-3710
Mailing Address - Country:US
Mailing Address - Phone:402-829-5239
Mailing Address - Fax:402-829-5343
Practice Address - Street 1:10077 S 134TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68138-3710
Practice Address - Country:US
Practice Address - Phone:402-829-5239
Practice Address - Fax:402-829-5343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NE25953336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2817178OtherNCPDP PROVIDER IDENTIFICATION NUMBER