Provider Demographics
NPI:1578852638
Name:ABELARDE, AUSTIN J
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:J
Last Name:ABELARDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5051 L ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68117-1328
Mailing Address - Country:US
Mailing Address - Phone:402-541-0823
Mailing Address - Fax:
Practice Address - Street 1:5051 L ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68117-1328
Practice Address - Country:US
Practice Address - Phone:402-541-0823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14276183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist