Organization
PROVIDENCE MEDICAL CENTER
Active
Other names
Providence Community Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY LUEDERS (PHARMACY DIRECTOR)
(402) 375-7920
Entity
Organization
Contact information
Practice address
803 PROVIDENCE RD STE 101, WAYNE, NE 68787-1590
(402) 375-8862
(402) 375-8863
Mailing address
1200 PROVIDENCE RD, WAYNE, NE 68787-1212
(402) 375-7920
(402) 375-7605
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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