Provider Demographics
NPI:1821683863
Name:SENIOR RX CARE OF NEBRASKA, LLC
Entity Type:Organization
Organization Name:SENIOR RX CARE OF NEBRASKA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-486-4404
Mailing Address - Street 1:5501 ALVO RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68514-3206
Mailing Address - Country:US
Mailing Address - Phone:888-486-4404
Mailing Address - Fax:
Practice Address - Street 1:5501 ALVO RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68514-3206
Practice Address - Country:US
Practice Address - Phone:888-486-4404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy