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Organization

WAHOO MAN LLC

Active
Other names
Medicine Man Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
JED LEWIS PHARMD (VICE PRESIDENT)
(402) 652-3217
Entity
Organization

Contact information

Practice address
526 N LINDEN ST, WAHOO, NE 68066-1961
(402) 443-4167
(402) 496-9788
Mailing address
526 N LINDEN ST, WAHOO, NE 68066-1961
(402) 443-4167

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary

Other

Enumeration date
08/16/2023
Last updated
08/16/2023
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