Provider Demographics
NPI:1114004504
Name:PONIDAY LLC
Entity Type:Organization
Organization Name:PONIDAY LLC
Other - Org Name:ARAPAHOE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MCCURDY
Authorized Official - Suffix:
Authorized Official - Credentials:RP
Authorized Official - Phone:308-962-7895
Mailing Address - Street 1:PO BOX 507
Mailing Address - Street 2:507 NEBRASKA AVE
Mailing Address - City:ARAPAHOE
Mailing Address - State:NE
Mailing Address - Zip Code:68922-0507
Mailing Address - Country:US
Mailing Address - Phone:308-962-7895
Mailing Address - Fax:308-962-7886
Practice Address - Street 1:507 NEBRASKA AVE
Practice Address - Street 2:
Practice Address - City:ARAPAHOE
Practice Address - State:NE
Practice Address - Zip Code:68922-0507
Practice Address - Country:US
Practice Address - Phone:308-962-7895
Practice Address - Fax:308-962-7886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18983336C0003X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47068580200Medicaid
2812837OtherNABP
NE=========00Medicaid