Individual
DONALD. FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.P.
Contact information
Practice address
601 N 30TH ST, OMAHA, NE 68131-2137
(402) 449-4570
(402) 449-5538
Mailing address
6665 N 168TH ST, OMAHA, NE 68116-5210
(402) 449-4570
(402) 449-5538
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8333
NE
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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