Provider Demographics
NPI:1457396319
Name:NAGANGAST PHARMACIES INC
Entity Type:Organization
Organization Name:NAGANGAST PHARMACIES INC
Other - Org Name:HOFMANN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:BOYD
Authorized Official - Middle Name:B
Authorized Official - Last Name:BATENHORST
Authorized Official - Suffix:
Authorized Official - Credentials:RP
Authorized Official - Phone:402-368-5385
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:103 EAST 2ND ST
Mailing Address - City:TILDEN
Mailing Address - State:NE
Mailing Address - Zip Code:68781-0190
Mailing Address - Country:US
Mailing Address - Phone:402-368-5385
Mailing Address - Fax:402-368-5386
Practice Address - Street 1:103 EAST 2ND ST
Practice Address - Street 2:
Practice Address - City:TILDEN
Practice Address - State:NE
Practice Address - Zip Code:68781
Practice Address - Country:US
Practice Address - Phone:402-368-5385
Practice Address - Fax:402-368-5386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE27703336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470538324Medicaid
08925OtherBLUE CROSS DME
08925OtherBLUE CROSS DME
NE470538324Medicaid