Individual
MR. WAYNE L TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD, MBA
Contact information
Practice address
2915 GRANT ST, OMAHA, NE 68111-3863
(402) 451-3553
Mailing address
PO BOX 34853, OMAHA, NE 68134-0853
(402) 250-1668
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11913
NE
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
11913
NE
Other
Enumeration date
02/24/2017
Last updated
02/24/2017
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