Organization
MEADOWLARK PHARMACY LLC
Active
Other names
Meadowlark Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHON LAMARQUE (OWNER/PRESIDENT/PIC/AO)
(831) 277-1871
Entity
Organization
Contact information
Practice address
18780 S 68TH ST STE B, HICKMAN, NE 68372-7083
(831) 277-1871
(402) 792-0010
Mailing address
6510 BEAVER CREEK LN, LINCOLN, NE 68516-3347
(831) 277-1871
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
711
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026716400
—
NE
01
—
2175934
PK
—
Enumeration date
01/26/2018
Last updated
07/19/2018
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