Organization
ALIVATION PHARMACY LLC
Active
Other names
Alivation Pharmacy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER DUFFY (OWNER)
(402) 476-5686
Entity
Organization
Contact information
Practice address
8550 CUTHILLS CIR, LINCOLN, NE 68526-9474
(402) 476-5686
(402) 484-0524
Mailing address
8550 CUTHILLS CIR, LINCOLN, NE 68526-9474
(402) 476-5686
(402) 484-0524
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
684
NE
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2166776
PK
—
Enumeration date
12/19/2016
Last updated
01/20/2017
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