Organization
ALEGENT CREIGHTON HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE TIESI (SENIOR DIRECTOR OF PHARMACY)
(402) 343-4546
Entity
Organization
Contact information
Practice address
11109 S 84TH ST, SUITE 1841, PAPILLION, NE 68046-4121
(402) 827-4200
(402) 827-4205
Mailing address
11109 S 84TH ST, SUITE 1841, PAPILLION, NE 68046-4121
(402) 827-4200
(402) 827-4205
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
2408
NE
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026519114
—
NE
01
—
2408
NEBRASKA COMMUNITY PHARMACY PERMIT
NE
Enumeration date
10/05/2006
Last updated
09/19/2025
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