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Organization
CROSIER PARK PHARMACY LLC
Active
Organization
CROSIER PARK PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT A KIRKEGAARD PHARM.D., BCPP (OWNER)
(402) 462-4600
Entity
Organization
Contact information
Practice address
405 E 14TH ST, HASTINGS, NE 68901-3204
(402) 462-4600
(402) 462-4605
Mailing address
405 E 14TH ST, HASTINGS, NE 68901-3204
(402) 462-4600
(402) 462-4605
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
190
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025267700
—
NE
01
—
2817091
NCPDP#
NE
Enumeration date
07/02/2005
Last updated
07/25/2013
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