Healthcare Provider Details
I. General information
NPI: 1922150275
Provider Name (Legal Business Name): FRIENDLY NEIGHBOR HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/17/2007
Last Update Date: 05/04/2020
Certification Date: 05/04/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
230 W ST JOSEPH ST
SPALDING NE
68665-6007
US
IV. Provider business mailing address
PO BOX 40
SPALDING NE
68665-0040
US
V. Phone/Fax
- Phone: 308-497-2250
- Fax: 308-497-2250
- Phone: 308-497-2250
- Fax: 308-497-2250
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 700 |
| License Number State | NE |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
KURT
J
CARRAHER
Title or Position: OWNER/MANAGER
Credential: PHARM D.
Phone: 308-497-2250