Organization
DAILEYS CLINIC PHCY INC
Active
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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