Provider Demographics
NPI:1003926809
Name:BEDEL'S INC
Entity Type:Organization
Organization Name:BEDEL'S INC
Other - Org Name:BEDEL'S DRIVE IN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STAFF PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MACH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:712-732-4819
Mailing Address - Street 1:409 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:STORM LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50588-1725
Mailing Address - Country:US
Mailing Address - Phone:712-732-4819
Mailing Address - Fax:712-732-2627
Practice Address - Street 1:409 W 5TH ST
Practice Address - Street 2:
Practice Address - City:STORM LAKE
Practice Address - State:IA
Practice Address - Zip Code:50588-1725
Practice Address - Country:US
Practice Address - Phone:712-732-4819
Practice Address - Fax:712-732-2627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
IA293336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0067496Medicaid
IA0067496Medicaid