MEDICARE: NEIGHBORHOOD LTC PHARMACY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336S0011X	Specialty Pharmacy
3	3336L0003X	Long Term Care Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194339515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEIGHBORHOOD LTC PHARMACY INC.

Provider Business Mailing Address
First Line	:	1265 S COTNER BLVD STE 30
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68510-4924
Country	:	US
Telephone Number	:	402-488-1184
Fax Number	:	402-488-1187

Provider Business Practice Location Address
First Line	:	2525 NW SOUTH OUTER RD STE D
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64015-1726
Country	:	US
Telephone Number	:	402-802-4874
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	MARISSA MCMAHON
Credential	:
Telephone Number	:	402-488-1184

Provider Enumeration Date	:	09/02/2020
Last Update Date	:	12/23/2024

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