Provider Demographics
NPI:1588777411
Name:D & L RX INC
Entity type:Organization
Organization Name:D & L RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ALVIN
Authorized Official - Last Name:POMAJZL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:402-643-2918
Mailing Address - Street 1:1519 W HIGHWAY 34
Mailing Address - Street 2:STE 1
Mailing Address - City:SEWARD
Mailing Address - State:NE
Mailing Address - Zip Code:68434-2361
Mailing Address - Country:US
Mailing Address - Phone:402-643-2918
Mailing Address - Fax:402-643-6956
Practice Address - Street 1:1519 W HIGHWAY 34
Practice Address - Street 2:STE 1
Practice Address - City:SEWARD
Practice Address - State:NE
Practice Address - Zip Code:68434-2361
Practice Address - Country:US
Practice Address - Phone:402-643-2918
Practice Address - Fax:402-643-6956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3024332B00000X, 332BP3500X, 3336C0003X, 332B00000X, 332BP3500X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025630900Medicaid
2811330OtherNABP/NCPDP
2811330OtherNABP/NCPDP