# KUBAT PHARMACY LOUISVILLE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Blakes Pharmacy - Long Term Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063174084
- **Authorized official:** ANTHONY SCHMID PHARMD (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (531) 233-4455

## Contact information

- **Practice address:** 213 MAIN ST, LOUISVILLE, NE 68037-6032
- **Practice address phone:** (402) 234-3025
- **Mailing address:** 4924 CENTER ST, OMAHA, NE 68106-3219

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 10/07/2021
- **Last updated:** 10/03/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 10026892200 | — | NE |