NPIMap

Organization Active NPI

Good Life Long Term Care

  • Long Term Care Pharmacy
  • Ord, NE
National Provider Identifier
1407958846
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
2334 Issued in NE
Legal business name
GOOD LIFE LONG TERM CARE
Practice address
127 S 16TH St
Ord, NE 68862
Phone
(308) 728-3295
Fax
(308) 728-3296
NPI assigned
Sep 5, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Angie Svobada, PHARM D, BCPS
Title
Owner/Pharmacist
Phone
(308) 728-3295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 2334 NE Primary

Addresses

Primary practice location

127 S 16TH St
Ord, NE 68862

Mailing address

127 S 16TH St
Ord, NE 68862

Other identifiers 1

IdentifierTypeStateIssuer
2815148OtherOTHER ID NUMBER-COMMERCIAL NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Good Life Health Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407958846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 S 16TH ST",
            "city": "ORD",
            "state": "NE",
            "postal_code": "68862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S 16TH ST",
            "city": "ORD",
            "state": "NE",
            "postal_code": "68862",
            "telephone_number": "308-728-3295",
            "fax_number": "308-728-3296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD LIFE LONG TERM CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SVOBADA",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "308-728-3295",
        "authorized_official_credential": "PHARM D, BCPS"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NE",
            "license": "2334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2815148",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ord, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.