Provider Demographics
NPI:1720046824
Name:OSMERA, ALLAN (RP)
Entity Type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:
Last Name:OSMERA
Suffix:
Gender:M
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WAHOO
Mailing Address - State:NE
Mailing Address - Zip Code:68066-1660
Mailing Address - Country:US
Mailing Address - Phone:402-443-1359
Mailing Address - Fax:
Practice Address - Street 1:14301 FIRST NATIONAL BANK PKWY
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-7201
Practice Address - Country:US
Practice Address - Phone:402-965-8035
Practice Address - Fax:402-493-2707
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist