Provider Demographics
NPI:1386729515
Name:USAVE PHARMACY MILFORD
Entity type:Organization
Organization Name:USAVE PHARMACY MILFORD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MALOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:308-324-6325
Mailing Address - Street 1:PO BOX 706
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NE
Mailing Address - Zip Code:68405
Mailing Address - Country:US
Mailing Address - Phone:402-761-2222
Mailing Address - Fax:
Practice Address - Street 1:610 1ST ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NE
Practice Address - Zip Code:68405-9611
Practice Address - Country:US
Practice Address - Phone:402-761-2222
Practice Address - Fax:402-761-2248
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:USAVE PHARMACY OF DAWSON COUNTY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-26
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336L0003X, 3336C0004X
NE24563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2816114OtherNCPDP
NE47083652200Medicaid
2055587OtherPK