Provider Demographics
NPI:1386657575
Name:BLAHA & BLAHA INC
Entity Type:Organization
Organization Name:BLAHA & BLAHA INC
Other - Org Name:ANDERSON PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:BLAHA
Authorized Official - Suffix:
Authorized Official - Credentials:RP
Authorized Official - Phone:308-728-5922
Mailing Address - Street 1:1429 M STREET
Mailing Address - Street 2:
Mailing Address - City:ORD
Mailing Address - State:NE
Mailing Address - Zip Code:68862
Mailing Address - Country:US
Mailing Address - Phone:308-728-5922
Mailing Address - Fax:308-729-7892
Practice Address - Street 1:1429 M STREET
Practice Address - Street 2:
Practice Address - City:ORD
Practice Address - State:NE
Practice Address - Zip Code:68862
Practice Address - Country:US
Practice Address - Phone:308-728-5922
Practice Address - Fax:308-729-7892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10183500000X
NE181183500000X
3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE4346840001Medicare NSC
NE4346840001Medicare PIN