Provider Demographics
NPI:1861714693
Name:CHILVERS, MARILYN LOUISE (RPH)
Entity type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:LOUISE
Last Name:CHILVERS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5808 S 144TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2603
Mailing Address - Country:US
Mailing Address - Phone:402-895-7220
Mailing Address - Fax:402-895-7926
Practice Address - Street 1:5808 S 144TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2603
Practice Address - Country:US
Practice Address - Phone:402-895-7220
Practice Address - Fax:402-895-7926
Is Sole Proprietor?:No
Enumeration Date:2010-02-21
Last Update Date:2010-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist