Provider Demographics
NPI:1811109366
Name:LEWANDOSKI, DENNIS JOHN (RPH)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:JOHN
Last Name:LEWANDOSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 S 163RD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-1416
Mailing Address - Country:US
Mailing Address - Phone:402-333-9616
Mailing Address - Fax:
Practice Address - Street 1:9707 Q ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-3272
Practice Address - Country:US
Practice Address - Phone:402-339-3054
Practice Address - Fax:402-331-6375
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8055183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist