Provider Demographics
NPI:1205049418
Name:TOOLEY DRUG COMPANY
Entity type:Organization
Organization Name:TOOLEY DRUG COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:CORT
Authorized Official - Last Name:TOOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-562-8627
Mailing Address - Street 1:2615 13TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-4915
Mailing Address - Country:US
Mailing Address - Phone:402-564-7205
Mailing Address - Fax:402-564-1979
Practice Address - Street 1:4306 38TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-1618
Practice Address - Country:US
Practice Address - Phone:402-562-8627
Practice Address - Fax:402-562-8637
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOOLEY DRUG COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-07
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid