Provider Demographics
NPI:1184907792
Name:HIPSHER, CRAIG D (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:D
Last Name:HIPSHER
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 1:2004 N 96TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-5814
Mailing Address - Country:US
Mailing Address - Phone:402-933-6722
Mailing Address - Fax:
Practice Address - Street 1:9001 BLONDO ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-6029
Practice Address - Country:US
Practice Address - Phone:402-393-8056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11362183500000X
IA19432183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist