Organization
PONIDAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM ERVIN (OFFICE MANAGER)
(308) 697-3400
Entity
Organization
Contact information
Practice address
624 PATTERSON ST, CAMBRIDGE, NE 69022
(308) 697-3400
(308) 697-3401
Mailing address
624 PATTERSON ST, PO BOX 117, CAMBRIDGE, NE 69022
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2586
NE
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2816253
OTHER ID NUMBER
—
Enumeration date
07/05/2006
Last updated
12/17/2021
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