Organization
KEYSTONE RX CORPORATION INC
Active
Other names
Dave's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID RANDOLPH (PRESIDENT)
(308) 760-1966
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
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
3016
NE
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146246
PK
—
Enumeration date
06/06/2014
Last updated
09/18/2025
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