Organization
KEYSTONE WHOLESALE CO
Active
Organization
KEYSTONE WHOLESALE CO
Active
Other names
KEY-MED PHARMACY CO.
Organization subpart
No
Provider details
NPI number
Authorized official
MANNY GOLDBERG RPH (PRES)
(402) 391-2659
Entity
Organization
Contact information
Practice address
7328 MAPLE ST, OMAHA, NE 68134-6829
(402) 391-2659
(402) 391-1524
Mailing address
7328 MAPLE ST, OMAHA, NE 68134-6829
(402) 391-2659
(402) 391-1524
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
1349
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025699700
—
NE
01
—
2800515
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/09/2007
Last updated
07/07/2010
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