Organization
GENEVA PHARMACY LLC
Active
Other names
Geneva Pharmacy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TANNER CHRISTIAN ANDERSON RPH (PIC/MANAGING MEMBER)
(402) 281-1956
Entity
Organization
Contact information
Practice address
20513 NICHOLAS CIR STE 3, ELKHORN, NE 68022-2971
(402) 759-9104
(402) 718-9421
Mailing address
20513 NICHOLAS CIR STE 3, ELKHORN, NE 68022-2971
(402) 759-9104
(402) 718-9421
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
677
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164318
PK
—
Enumeration date
09/22/2016
Last updated
01/17/2018
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