Healthcare Provider Details

I. General information

NPI: 1376552851
Provider Name (Legal Business Name): FRIENDLY NEIGHBOR HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 07/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 S 2ND ST
ELGIN NE
68636-4409
US

IV. Provider business mailing address

PO BOX 429
ELGIN NE
68636-0429
US

V. Phone/Fax

Practice location:
  • Phone: 402-843-5555
  • Fax: 402-843-5551
Mailing address:
  • Phone: 402-843-5555
  • Fax: 402-843-5551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2751
License Number StateNE

VIII. Authorized Official

Name: MR. KURT J CARRAHER
Title or Position: OWNER/MANAGER
Credential:
Phone: 402-843-5555