Organization
EXTENDCARE THE PHARMACY INC
Active
Other names
RelyCare LTC Lincoln
Organization subpart
No
Provider details
NPI number
Authorized official
STEVAN OSENBAUGH (PRESIDENT)
(402) 466-7283
Entity
Organization
Contact information
Practice address
1219 N COTNER BLVD, LINCOLN, NE 68505-1837
(402) 466-6083
(402) 466-6086
Mailing address
1219 N COTNER BLVD, LINCOLN, NE 68505-1837
(402) 466-6083
(402) 466-6086
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
2978
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2055930
PK
—
Enumeration date
11/02/2007
Last updated
10/19/2016
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