Provider Demographics
NPI:1699341933
Name:GUERRERO, JOSE (PHARMD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-4503
Mailing Address - Country:US
Mailing Address - Phone:308-384-7372
Mailing Address - Fax:308-384-6067
Practice Address - Street 1:423 W 4TH ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-4503
Practice Address - Country:US
Practice Address - Phone:308-384-7372
Practice Address - Fax:308-384-6067
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE134193336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy