Provider Demographics
NPI:1922150275
Name:FRIENDLY NEIGHBOR HEALTHCARE, LLC
Entity Type:Organization
Organization Name:FRIENDLY NEIGHBOR HEALTHCARE, LLC
Other - Org Name:SPALDING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
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:308-497-2250
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:SPALDING
Mailing Address - State:NE
Mailing Address - Zip Code:68665-0040
Mailing Address - Country:US
Mailing Address - Phone:308-497-2250
Mailing Address - Fax:308-497-2250
Practice Address - Street 1:230 W ST JOSEPH ST
Practice Address - Street 2:
Practice Address - City:SPALDING
Practice Address - State:NE
Practice Address - Zip Code:68665-6007
Practice Address - Country:US
Practice Address - Phone:308-497-2250
Practice Address - Fax:308-497-2250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7003336C0003X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2053697OtherPK
NE10026660800Medicaid