# GOOD LIFE LONG TERM CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407958846
- **Authorized official:** ANGIE SVOBADA PHARM D, BCPS (OWNER/PHARMACIST)
- **Authorized official phone:** (308) 728-3295

## Contact information

- **Practice address:** 127 S 16TH ST, ORD, NE 68862
- **Practice address phone:** (308) 728-3295
- **Practice address fax:** (308) 728-3296
- **Mailing address:** 127 S 16TH ST, ORD, NE 68862

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 2334 | NE | Yes |

## Other

- **Enumeration date:** 09/05/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2815148 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |