Organization
TGSC VENTURES, LLC
Active
Other names
Frontier Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER GAVIN STURGEON (PIC)
(308) 529-1224
Entity
Organization
Contact information
Practice address
540 S 8TH AVE, BROKEN BOW, NE 68822-2456
(308) 872-5231
(308) 872-2377
Mailing address
540 S 8TH AVE, BROKEN BOW, NE 68822-2456
(308) 872-5231
(308) 872-2377
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026649601
—
NE
Enumeration date
01/08/2020
Last updated
06/15/2021
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