Provider Demographics
NPI:1841215688
Name:B.E. DRUG, INC.
Entity Type:Organization
Organization Name:B.E. DRUG, INC.
Other - Org Name:BLUE EARTH DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIERKE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:507-526-2121
Mailing Address - Street 1:125 S GROVE ST
Mailing Address - Street 2:STE 1
Mailing Address - City:BLUE EARTH
Mailing Address - State:MN
Mailing Address - Zip Code:56013-2521
Mailing Address - Country:US
Mailing Address - Phone:507-526-2121
Mailing Address - Fax:507-526-2298
Practice Address - Street 1:125 S GROVE ST
Practice Address - Street 2:STE 1
Practice Address - City:BLUE EARTH
Practice Address - State:MN
Practice Address - Zip Code:56013-2521
Practice Address - Country:US
Practice Address - Phone:507-526-2121
Practice Address - Fax:507-526-2298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN261899-5183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0526962Medicaid
136605OtherUCARE
MN999638900Medicaid
MN85D23BLOtherBLUE CROSS BLUE SHIELD
2423678OtherNCPDP NUMBER
1315640001Medicare ID - Type Unspecified