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Organization
ARRX INC
Active
Organization
ARRX INC
Active
Other names
LAKE CREST PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA RUSE RP (PRESIDENT/OWNER)
(402) 988-7145
Entity
Organization
Contact information
Practice address
620 MAIN ST, STE B, ADAMS, NE 68301-8277
(402) 988-7145
(402) 988-2096
Mailing address
PO BOX 972, ADAMS, NE 68301-0972
(402) 988-7145
(402) 988-2096
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
2885
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025580600
—
NE
01
—
2054536
PK
—
Enumeration date
07/13/2009
Last updated
04/24/2017
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