Provider Demographics
NPI:1194170480
Name:FRIENDLY NEIGHBOR HEALTHCARE, LLC
Entity type:Organization
Organization Name:FRIENDLY NEIGHBOR HEALTHCARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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:
Authorized Official - Phone:402-395-2184
Mailing Address - Street 1:245 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:NE
Mailing Address - Zip Code:68620-1217
Mailing Address - Country:US
Mailing Address - Phone:402-395-2184
Mailing Address - Fax:402-395-2185
Practice Address - Street 1:245 S 4TH ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NE
Practice Address - Zip Code:68620-1217
Practice Address - Country:US
Practice Address - Phone:402-395-2184
Practice Address - Fax:402-395-2185
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRIENDLY NEIGHBOR HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-25
Last Update Date:2017-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026660803Medicaid