Provider Demographics
NPI:1336124320
Name:STEFFEN DRUG INC
Entity Type:Organization
Organization Name:STEFFEN DRUG INC
Other - Org Name:MANION'S DRUG STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:STEFFEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:402-254-3549
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:719 MAIN STREET
Mailing Address - City:CREIGHTON
Mailing Address - State:NE
Mailing Address - Zip Code:68729-0085
Mailing Address - Country:US
Mailing Address - Phone:402-358-3535
Mailing Address - Fax:402-358-3823
Practice Address - Street 1:719 MAIN ST
Practice Address - Street 2:
Practice Address - City:CREIGHTON
Practice Address - State:NE
Practice Address - Zip Code:68729-4002
Practice Address - Country:US
Practice Address - Phone:402-358-3535
Practice Address - Fax:402-358-3823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2940314000000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026038000Medicaid
2136351OtherPK
2136351OtherPK