Provider Demographics
NPI:1992800114
Name:DENDINGER DRUG, LLC
Entity type:Organization
Organization Name:DENDINGER DRUG, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:DENDINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:402-582-4202
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NE
Mailing Address - Zip Code:68769-0217
Mailing Address - Country:US
Mailing Address - Phone:402-582-4202
Mailing Address - Fax:402-582-4204
Practice Address - Street 1:103 S. MAIN ST.
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NE
Practice Address - Zip Code:68769-0217
Practice Address - Country:US
Practice Address - Phone:402-582-4204
Practice Address - Fax:402-582-4204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2518332B00000X
3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026807700Medicaid
NE=========00Medicaid