Healthcare Provider Details

I. General information

NPI: 1518592856
Provider Name (Legal Business Name): DENDINGER DRUG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2020
Last Update Date: 03/06/2020
Certification Date: 03/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 S MAIN ST
PLAINVIEW NE
68769-4121
US

IV. Provider business mailing address

PO BOX 217
PLAINVIEW NE
68769-0217
US

V. Phone/Fax

Practice location:
  • Phone: 402-582-4202
  • Fax: 402-582-4204
Mailing address:
  • Phone: 402-582-4202
  • Fax: 402-582-4204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier10026807700
Identifier TypeMEDICAID
Identifier StateNE
Identifier Issuer

VIII. Authorized Official

Name: ASHLEY DENDINGER
Title or Position: OWNER/PIC
Credential: PHARM.D.
Phone: 402-582-4202