Organization
14TH AVENUE PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT LOUDERBACK (PRESIDENT)
(402) 489-1135
Entity
Organization
Contact information
Practice address
1200 N 14TH AVE, PASCO, WA 99301-4192
(509) 547-8360
Mailing address
8055 O ST, LINCOLN, NE 68510-2565
(402) 489-1135
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
06/16/2006
Last updated
08/22/2020
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