Provider Demographics
NPI:1134605322
Name:CALKINS, SAMANTHA R (PHARMD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:R
Last Name:CALKINS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17118 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-3075
Mailing Address - Country:US
Mailing Address - Phone:402-841-3229
Mailing Address - Fax:
Practice Address - Street 1:8525 S 71ST PLZ
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68133-2100
Practice Address - Country:US
Practice Address - Phone:402-597-8982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16104183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist