Provider Demographics
NPI:1518119619
Name:CARRAHER, KURT J (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:KURT
Middle Name:J
Last Name:CARRAHER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12862183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE12862OtherSTATE OF NEBRASKA