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Organization

INNOVATIVE RX, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RACHEL DALY PHARMD, R.P. (PHARMACIST)
(308) 708-5070
Entity
Organization

Contact information

Practice address
416 W 48TH ST STE 20, KEARNEY, NE 68845-1315
(308) 430-3668
Mailing address
416 W 48TH ST STE 20, KEARNEY, NE 68845-1315

Taxonomy

Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
754
PHARMACY LICENSE NUMBER
NE
Enumeration date
07/31/2019
Last updated
09/11/2019
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