Provider Demographics
NPI:1679636856
Name:STEFFEN DRUG INC
Entity Type:Organization
Organization Name:STEFFEN DRUG INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:D
Authorized Official - Last Name:STEFFEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:402-254-3549
Mailing Address - Street 1:214 N BROADWAY AVE
Mailing Address - Street 2:PO BOX 248
Mailing Address - City:HARTINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68739-4619
Mailing Address - Country:US
Mailing Address - Phone:402-254-3549
Mailing Address - Fax:402-254-3545
Practice Address - Street 1:214 N BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:HARTINGTON
Practice Address - State:NE
Practice Address - Zip Code:68739-4619
Practice Address - Country:US
Practice Address - Phone:402-254-3549
Practice Address - Fax:402-254-3545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE24023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE1265590001Medicare NSC