Provider Demographics
NPI:1023092194
Name:NOE, CRAIG DOUGLAS (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:DOUGLAS
Last Name:NOE
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 1:4021 AVENUE B
Mailing Address - Street 2:INPATIENT PHARMACY
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-4602
Mailing Address - Country:US
Mailing Address - Phone:308-630-1262
Mailing Address - Fax:308-630-1860
Practice Address - Street 1:4021 AVENUE B
Practice Address - Street 2:INPATIENT PHARMACY
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4602
Practice Address - Country:US
Practice Address - Phone:308-630-1262
Practice Address - Fax:308-630-1860
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE115761835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy