Individual
JASON LAUDENKLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13660 CALIFORNIA ST, OMAHA, NE 68154-5233
(402) 965-8800
Mailing address
PO BOX 407, BOYS TOWN, NE 68010-0407
(402) 965-8800
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
4611
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4611
NE PHARMACY TECH
NE
Enumeration date
11/14/2014
Last updated
11/14/2014
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