Provider Demographics
NPI:1508390733
Name:FRIENDLY NEIGHBOR HEALTHCARE, LLC
Entity Type:Organization
Organization Name:FRIENDLY NEIGHBOR HEALTHCARE, LLC
Other - Org Name:WELLS DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARRAHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:402-395-2184
Mailing Address - Street 1:113 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:NE
Mailing Address - Zip Code:68620-1215
Mailing Address - Country:US
Mailing Address - Phone:402-395-2184
Mailing Address - Fax:402-395-2185
Practice Address - Street 1:113 S 4TH ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NE
Practice Address - Zip Code:68620-1215
Practice Address - Country:US
Practice Address - Phone:402-395-2184
Practice Address - Fax:402-395-2185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-13
Last Update Date:2017-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE183500000X, 332B00000X, 3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy