Healthcare Provider Details
I. General information
NPI: 1992800114
Provider Name (Legal Business Name): DENDINGER DRUG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/13/2006
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
103 S. MAIN ST.
PLAINVIEW NE
68769-0217
US
IV. Provider business mailing address
PO BOX 217
PLAINVIEW NE
68769-0217
US
V. Phone/Fax
- Phone: 402-582-4204
- Fax: 402-582-4204
- Phone: 402-582-4202
- Fax: 402-582-4204
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 2518 |
| License Number State | NE |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 10026807700 |
| Identifier Type | MEDICAID |
| Identifier State | NE |
| Identifier Issuer | |
VIII. Authorized Official
Name: DR.
ASHLEY
RENEE
DENDINGER
Title or Position: OWNER/PIC
Credential: PHARM.D.
Phone: 402-582-4202