Organization
SYSTEMS HEALTHCORP INC
Active
Other names
QUANTUM MED PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ESSIEN EDET RP (PRESIDENT)
(402) 339-4036
Entity
Organization
Contact information
Practice address
3744 S 132ND ST, OMAHA, NE 68144-3608
(402) 339-4036
(402) 339-4081
Mailing address
3744 S 132ND ST, OMAHA, NE 68144-3608
(402) 339-4036
(402) 339-4081
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
2783
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2815489
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
4119822600
—
NE
Enumeration date
08/10/2006
Last updated
03/25/2010
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