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Organization

FOUR STAR DRUG OF WAVERLY

Active
Parent organization
FOUR STAR DRUG OF BETHANY, INC
Other names
Four Star Drug
Organization subpart
Yes

Provider details

NPI number
Legal business name
FOUR STAR DRUG OF BETHANY, INC
Authorized official
DR. MONTY LEE SCHEELE PHARM.D. (DIRECTOR OF PHARMACY OPERATIONS)
(402) 434-7701
Entity
Organization

Contact information

Practice address
13851 GUILDFORD ST, SUITE D, WAVERLY, NE 68462
(402) 786-2222
(402) 786-2502
Mailing address
13851 GUILDFORD ST, SUITE D, WAVERLY, NE 68462
(402) 786-2222
(402) 786-2502

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
278
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
47607128202
NE
Enumeration date
11/17/2006
Last updated
06/25/2008
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