Provider Demographics
NPI:1013227735
Name:KS DRUG INC
Entity Type:Organization
Organization Name:KS DRUG INC
Other - Org Name:GRETNA DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MRS.
Authorized Official - Prefix:
Authorized Official - First Name:KHATU
Authorized Official - Middle Name:
Authorized Official - Last Name:ERLBACHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-490-2474
Mailing Address - Street 1:PO BOX 898
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028-0898
Mailing Address - Country:US
Mailing Address - Phone:712-490-2474
Mailing Address - Fax:
Practice Address - Street 1:820 VILLAGE SQ
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:NE
Practice Address - Zip Code:68028-7914
Practice Address - Country:US
Practice Address - Phone:402-332-5990
Practice Address - Fax:402-332-0266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-15
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE435333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2818055OtherNCPDP PROVIDER IDENTIFICATION NUMBER