Provider Demographics
NPI:1245852185
Name:SERVICE DRUGS, INC.
Entity type:Organization
Organization Name:SERVICE DRUGS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-430-5400
Mailing Address - Street 1:302 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHADRON
Mailing Address - State:NE
Mailing Address - Zip Code:69337-2395
Mailing Address - Country:US
Mailing Address - Phone:308-432-2400
Mailing Address - Fax:308-432-6759
Practice Address - Street 1:202 MAIN ST.
Practice Address - Street 2:
Practice Address - City:CRAWFORD
Practice Address - State:NE
Practice Address - Zip Code:69339-1026
Practice Address - Country:US
Practice Address - Phone:308-665-4138
Practice Address - Fax:308-665-4139
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SERVICE DRUGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy