Organization
HAVELOCK NEIGHBORHOOD PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITCHELL DEINES RP (PRESIDENT)
(402) 223-4779
Entity
Organization
Contact information
Practice address
5844 FREMONT ST, LINCOLN, NE 68507-1661
(402) 466-5555
(402) 465-8593
Mailing address
5844 FREMONT ST, LINCOLN, NE 68507-1661
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
287
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2815491
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
47081569700
—
NE
Enumeration date
02/27/2007
Last updated
09/12/2007
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