Provider Demographics
NPI:1144941055
Name:BLOOD PHARMACY, LLC
Entity type:Organization
Organization Name:BLOOD PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:BLOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, RP
Authorized Official - Phone:402-806-2112
Mailing Address - Street 1:410 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NELIGH
Mailing Address - State:NE
Mailing Address - Zip Code:68756-1423
Mailing Address - Country:US
Mailing Address - Phone:402-887-5426
Mailing Address - Fax:402-887-4595
Practice Address - Street 1:410 MAIN ST
Practice Address - Street 2:
Practice Address - City:NELIGH
Practice Address - State:NE
Practice Address - Zip Code:68756-1423
Practice Address - Country:US
Practice Address - Phone:402-887-5426
Practice Address - Fax:402-887-4595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies