Provider Demographics
NPI:1710028097
Name:VOGT PHARMACIES INC
Entity type:Organization
Organization Name:VOGT PHARMACIES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:VOGT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:402-578-9734
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:123 E. GARDINER STREET
Mailing Address - City:VALLEY
Mailing Address - State:NE
Mailing Address - Zip Code:68064
Mailing Address - Country:US
Mailing Address - Phone:402-359-2284
Mailing Address - Fax:402-359-2285
Practice Address - Street 1:123 E. GARDINER STREET
Practice Address - Street 2:
Practice Address - City:VALLEY
Practice Address - State:NE
Practice Address - Zip Code:68064
Practice Address - Country:US
Practice Address - Phone:402-359-2284
Practice Address - Fax:402-359-2285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NE30923336L0003X
NE3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026294301Medicaid
2160505OtherPK