Provider Demographics
NPI:1194070003
Name:B E DRUG INC
Entity type:Organization
Organization Name:B E DRUG INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIERKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-526-2121
Mailing Address - Street 1:125 S GROVE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BLUE EARTH
Mailing Address - State:MN
Mailing Address - Zip Code:56013-2521
Mailing Address - Country:US
Mailing Address - Phone:507-526-2122
Mailing Address - Fax:507-526-2298
Practice Address - Street 1:125 S GROVE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BLUE EARTH
Practice Address - State:MN
Practice Address - Zip Code:56013-2521
Practice Address - Country:US
Practice Address - Phone:507-526-2122
Practice Address - Fax:507-526-2298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MN2641373336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN283478300Medicaid
2136487OtherPK
1315640001Medicare NSC