MEDICARE: GOOD LIFE HEALTH SERVICES INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	8653	NE
2	333600000X	Pharmacy	2344	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2815174	OTHER		NCPDP

General Provider Information

NPI Number	:	1912091091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOOD LIFE HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	PO BOX 508
Second Line	:
City	:	LOUP CITY
State	:	NE
Zip	:	68853
Country	:	US
Telephone Number	:	308-745-1614
Fax Number	:	308-745-0769

Provider Business Practice Location Address
First Line	:	727 O STREET
Second Line	:
City	:	LOUP CITY
State	:	NE
Zip	:	68853
Country	:	US
Telephone Number	:	308-745-1614
Fax Number	:	308-745-1614

Authorized Official
Title or Position	:	OWNER PHARMACIST
Name	:	MR. JAMES FRANK ANDREESEN
Credential	:	RP
Telephone Number	:	308-745-1614

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	09/11/2025

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Directions to “GOOD LIFE HEALTH SERVICES INC ” Practice Location

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