Organization Name: | NYBERG PHARMACY INC |
NPI Number: | 1245344217 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DWIGHT NYBERG (OWNER/PIC) |
Mailing Address: | 315 S Ash Buffalo |
State: | MO US |
Postal Code: | 656220860 |
Phone Number: | 4173452321 |
Fax Number: | 4173458837 |
NPI Enumeration Date: | 08/18/2006 |
NPI Last Update Date: | 01/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |