Provider Demographics
NPI:1801096094
Name:NORFOLK VETERANS HOME
Entity type:Organization
Organization Name:NORFOLK VETERANS HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:ELISSA
Authorized Official - Middle Name:K
Authorized Official - Last Name:CARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:402-370-4465
Mailing Address - Street 1:600 E BENJAMIN AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-0830
Mailing Address - Country:US
Mailing Address - Phone:402-370-4465
Mailing Address - Fax:402-370-4466
Practice Address - Street 1:600 E BENJAMIN AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-0830
Practice Address - Country:US
Practice Address - Phone:402-370-4465
Practice Address - Fax:402-370-4466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2488332100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332100000XSuppliersDepartment of Veterans Affairs (VA) Pharmacy