Provider Demographics
NPI:1811059652
Name:MARSHALL PHARMACY
Entity type:Organization
Organization Name:MARSHALL PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-678-2551
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:SAINT EDWARD
Mailing Address - State:NE
Mailing Address - Zip Code:68660-0187
Mailing Address - Country:US
Mailing Address - Phone:402-678-2551
Mailing Address - Fax:402-678-2550
Practice Address - Street 1:3RD & BEAVER
Practice Address - Street 2:
Practice Address - City:ST. EDWARD
Practice Address - State:NE
Practice Address - Zip Code:68660
Practice Address - Country:US
Practice Address - Phone:402-678-2551
Practice Address - Fax:402-678-2550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy