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Organization

ALEGENT CREIGHTON HEALTH

Active
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Organization

ALEGENT CREIGHTON HEALTH

Active
Other names
CHI Health Pharmacy - Valley View
Organization subpart
No

Provider details

NPI number
Authorized official
MIKE TIESI DO, RP (DIVISION VP PHARMACY)
(402) 343-4546
Entity
Organization

Contact information

Practice address
1288 VALLEY VIEW DRIVE, PHARMACY STE 101, COUNCIL BLUFFS, IA 51503-5245
(000) 000-0000
Mailing address
7261 MERCY ROAD, ATTN: CARIE WILDERMAN /SOUTH BLDG 2ND FLR, OMAHA, NE 68124
(402) 343-4546

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PENDING
IOWA PHARMACY LICENSE
IA
01
PENDING
NCPDP #
NE
05
PENDING
IA
Enumeration date
03/04/2019
Last updated
03/07/2023
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