Organization
TDCS, LLC
Active
Other names
MEDWELLRX
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY S DECKER (PRESIDENT)
(402) 592-5244
Entity
Organization
Contact information
Practice address
13831 CHALCO VALLEY PKWY, SUITE 101, OMAHA, NE 68138-6145
(402) 763-6520
(402) 763-6521
Mailing address
13831 CHALCO VALLEY PKWY, SUITE 101, OMAHA, NE 68138-6145
(402) 763-6520
(402) 763-6521
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336L0003X
Long Term Care Pharmacy
Primary
269
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100254471-00
—
NE
Enumeration date
12/29/2006
Last updated
01/11/2012
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