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Organization

PROFESSIONAL COMPOUNDING CENTER OF SOUTHEAST NEBRASKA INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MITCHELL E DEINES RP (PRESIDENT)
(402) 223-4774
Entity
Organization

Contact information

Practice address
910 E COURT ST, STE B, BEATRICE, NE 68310-4085
(402) 223-4774
(402) 223-5610
Mailing address
910 E COURT ST, STE B, BEATRICE, NE 68310-4085
(402) 223-4774
(402) 223-5610

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2345
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
36931
BLUE CROSS
05
47074248301
NE
Enumeration date
08/09/2005
Last updated
08/22/2020
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