Organization
KEYSTONE RX CORPORATION INC
Active
Other names
Dave's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BLANCHE ANNE RANDOLPH (OWNER/MANAGER)
(308) 487-5212
Entity
Organization
Contact information
Practice address
508 NIOBRARA AVE, HEMINGFORD, NE 69348-9703
(308) 487-5212
(308) 487-5235
Mailing address
PO BOX 95, HEMINGFORD, NE 69348-0095
(308) 487-5212
(308) 487-5235
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100264060
—
NE
Enumeration date
09/25/2020
Last updated
02/17/2025
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