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
—
—
3336L0003X
Long Term Care Pharmacy
2817
NE
3336L0003X
Long Term Care Pharmacy
Primary
—
—
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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