Provider Demographics
NPI:1013293521
Name:LERNER, GEORGE M (RPH)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:M
Last Name:LERNER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 N 216TH ST
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-2912
Mailing Address - Country:US
Mailing Address - Phone:402-289-1750
Mailing Address - Fax:
Practice Address - Street 1:9001 BLONDO ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-6029
Practice Address - Country:US
Practice Address - Phone:402-393-8056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9802183500000X
IA16311183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist