Organization
MDSLC INC
Active
Other names
Stockmen's Drug
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL COOKSTON (OWNER/PRESIDENT/PIC/AO)
(308) 282-1114
Entity
Organization
Contact information
Practice address
116 N MAIN ST, GORDON, NE 69343-1524
(308) 282-1114
(308) 282-2250
Mailing address
116 N MAIN ST, GORDON, NE 69343-1524
(308) 282-1114
(308) 282-2250
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
3021
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026444200/8534700
—
NE
01
—
2145896
PK
—
Enumeration date
07/31/2006
Last updated
07/19/2018
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