Provider Demographics
NPI:1043324478
Name:B & R STORES, INC
Entity type:Organization
Organization Name:B & R STORES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:LEO
Authorized Official - Last Name:SCHMID
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:402-464-6297
Mailing Address - Street 1:1709 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-2552
Mailing Address - Country:US
Mailing Address - Phone:402-474-2102
Mailing Address - Fax:402-434-7397
Practice Address - Street 1:1709 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-2552
Practice Address - Country:US
Practice Address - Phone:402-474-2102
Practice Address - Fax:402-434-7397
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:B & R STORES , INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-19
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE21213336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0755930004Medicare ID - Type Unspecified