Organization
INNOVATIVE PHARMACISTS INC
Active
Other names
L T Pedley Drug
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAMI L HANSON PHARMD, R.P. (PHARMACIST IN CHARGE)
(308) 832-2816
Entity
Organization
Contact information
Practice address
419 N COLORADO AVE, MINDEN, NE 68959-1654
(308) 832-2816
(308) 832-2047
Mailing address
PO BOX 108, 419 N COLORADO AVE, MINDEN, NE 68959-0108
(308) 832-2816
(308) 832-2047
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2394
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2803422
NCPDP
NE
Enumeration date
10/24/2006
Last updated
04/20/2008
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