Provider Demographics
NPI:1982187654
Name:US PHARMACY
Entity Type:Organization
Organization Name:US PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-204-8516
Mailing Address - Street 1:7914 W DODGE RD STE 144
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3417
Mailing Address - Country:US
Mailing Address - Phone:855-204-8516
Mailing Address - Fax:712-248-8710
Practice Address - Street 1:7914 W DODGE RD STE 144
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3417
Practice Address - Country:US
Practice Address - Phone:855-204-8516
Practice Address - Fax:712-248-8710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========OtherDME