Organization
DAILEYS CLINIC PHCY INC
Active
Other names
COLEMAN CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY LORENZ RPH (OWNER AND PIC)
(402) 443-3979
Entity
Organization
Contact information
Practice address
735 W 10TH ST, WAHOO, NE 68066-1100
(402) 443-3979
(402) 443-5527
Mailing address
735 W 10TH ST, WAHOO, NE 68066-1100
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2196
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2814398
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
01/30/2007
Last updated
08/22/2020
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