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Organization
BENS DRUG STORE INC
Active
Organization
BENS DRUG STORE INC
Active
Other names
Midwest LTC Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CODY LOBEDA PHARMD (OWNER)
(308) 398-0538
Entity
Organization
Contact information
Practice address
2208 N WEBB RD UNIT 3, GRAND ISLAND, NE 68803-1739
(308) 398-0538
(308) 398-0539
Mailing address
3003 FRONTAGE RD, STE 2, GRAND ISLAND, NE 68803-5500
(308) 398-0538
(308) 398-0539
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
2817
NE
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025304200
—
NE
01
—
2055891
PK
—
Enumeration date
05/08/2007
Last updated
02/01/2021
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