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General NPI Number Information
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NPI Number | 1619668258
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Entity Type | Organization
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Legal Business Name | NEIGHBORHOOD LTC PHARMACY INC.
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Dates
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Enumeration Date | 05/16/2023
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 10711 JUSTIN DR
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City | URBANDALE
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State | IA
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Zip | 50322-3720
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Country | US
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Telephone | 515-989-8301
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Fax | 515-989-8302
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Provider Business Mailing Address
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Address Line | 1265 S COTNER BLVD STE 30
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City | LINCOLN
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State | NE
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Zip | 68510-4924
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Country | US
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Telephone | 402-488-1184
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Fax | 402-488-1187
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Authorized Official
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Title or Position | COO
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Name | MARISSA MCMAHON
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Credential | PHARMD
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Telephone | 402-488-1184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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