Provider Demographics
NPI:1932614930
Name:HELLBUSCH, CHET EDWARD
Entity Type:Individual
Prefix:
First Name:CHET
Middle Name:EDWARD
Last Name:HELLBUSCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 23RD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-3304
Mailing Address - Country:US
Mailing Address - Phone:402-563-3588
Mailing Address - Fax:
Practice Address - Street 1:2320 23RD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-3304
Practice Address - Country:US
Practice Address - Phone:402-563-3588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist