Organization
FOUR STAR DRUG OF WAVERLY
Active
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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