Provider Demographics
NPI:1689980807
Name:ELMBORG, JOEL C (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:C
Last Name:ELMBORG
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10504 S 15 STREET
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123
Mailing Address - Country:US
Mailing Address - Phone:402-929-0463
Mailing Address - Fax:402-592-2501
Practice Address - Street 1:10504 S 15 STREET
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123
Practice Address - Country:US
Practice Address - Phone:402-929-0463
Practice Address - Fax:402-592-2501
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13418183500000X
NE1004227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered