Provider Demographics
NPI:1336153691
Name:PHARMACY EXPRESS SERVICES INC
Entity Type:Organization
Organization Name:PHARMACY EXPRESS SERVICES INC
Other - Org Name:NO FRILLS PHARMACY EXPRESS #5
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-827-3500
Mailing Address - Street 1:PO BOX 241148
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-5148
Mailing Address - Country:US
Mailing Address - Phone:402-827-3500
Mailing Address - Fax:
Practice Address - Street 1:7402 N 30TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68112-2722
Practice Address - Country:US
Practice Address - Phone:402-827-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE25733336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2816467OtherNCPDP
2816467OtherNCPDP
2816467OtherNCPDP