Jerry L Lagerstrom

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2349 Issued in NE

Legal business name

JERRY L LAGERSTROM

Practice address

517 Main St
Plattsmouth, NE 68048-1963

Phone

(402) 296-4455

Fax

(402) 296-4400

NPI assigned

Feb 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jerry Lagerstrom, RPH

Title

Owner

Phone

(402) 296-4455

Specialties & licenses 1

Addresses

Other names 1

• HERITAGE PHARMACY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1902946239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 MAIN STREET",
            "city": "PLATTSMOUTH",
            "state": "NE",
            "postal_code": "68048",
            "telephone_number": "402-296-4455",
            "fax_number": "402-296-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 MAIN ST",
            "city": "PLATTSMOUTH",
            "state": "NE",
            "postal_code": "680481963",
            "telephone_number": "402-296-4455",
            "fax_number": "402-296-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY L LAGERSTROM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "LAGERSTROM",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-296-4455",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NE",
            "license": "2349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HERITAGE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Plattsmouth, NE
• Providers in Plattsmouth, NE by specialty
• Community/Retail Pharmacy in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.