Organization
NORTHEAST NEBRASKA LTC, LLC
Active
Parent organization
VITAL CARE PHARMACY OF NORFOLK, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
VITAL CARE PHARMACY OF NORFOLK, INC
Authorized official
MITCHELL E DEINES RP (MEMBER/DIRECTOR)
(402) 223-4779
Entity
Organization
Contact information
Practice address
120 N 27TH ST, SUITE 200, NORFOLK, NE 68701-3286
(402) 371-3444
(402) 371-3566
Mailing address
120 N 27TH ST, SUITE 200, NORFOLK, NE 68701-3286
(402) 371-3444
(402) 371-3566
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
605
NE
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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