Organization
NEIGHBORHOOD LTC PHARMACY INC.
Active
Other names
Neighborhood LTC Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA MCMAHON PHARMD (COO)
(402) 488-1184
Entity
Organization
Contact information
Practice address
690 N COFCO CENTER CT STE 100, PHOENIX, AZ 85008-6466
(602) 396-7330
(602) 688-8016
Mailing address
1265 S COTNER BLVD STE 30, LINCOLN, NE 68510-4924
(402) 488-1184
(402) 488-1187
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158929
—
AZ
05
—
1699425959
—
NC
05
—
4286581
—
UT
05
—
61380849
—
NM
Enumeration date
03/28/2022
Last updated
10/09/2024
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