Provider Demographics
NPI:1245312594
Name:SVOBODA, ANGELA K (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:K
Last Name:SVOBODA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 S 16TH ST
Mailing Address - Street 2:GOOD LIFE PHARMACY
Mailing Address - City:ORD
Mailing Address - State:NE
Mailing Address - Zip Code:68862-1415
Mailing Address - Country:US
Mailing Address - Phone:308-728-3295
Mailing Address - Fax:308-728-3296
Practice Address - Street 1:125 S 16TH ST
Practice Address - Street 2:
Practice Address - City:ORD
Practice Address - State:NE
Practice Address - Zip Code:68862-1415
Practice Address - Country:US
Practice Address - Phone:308-728-3295
Practice Address - Fax:308-728-3296
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE102971835G0303X, 1835P1200X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy