NPIMap

Organization Active NPI

Keystone RX Corporation Inc

Doing business as Dave's Pharmacy

  • Community/Retail Pharmacy
  • Hemingford, NE
National Provider Identifier
1922411925
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
3016 Issued in NE
Legal business name
KEYSTONE RX CORPORATION INC
Doing business as
Dave's Pharmacy
Practice address
508 Niobrara Ave
Hemingford, NE 69348-9703
Phone
(308) 487-5212
Fax
(308) 487-5235
NPI assigned
Jun 6, 2014
Last updated
Sep 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Randolph
Title
President
Phone
(308) 760-1966

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 3016 NE Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

508 Niobrara Ave
Hemingford, NE 69348-9703

Mailing address

PO Box 95
Hemingford, NE 69348-0095
Phone (308) 487-5212

Other identifiers 1

IdentifierTypeStateIssuer
2146246OtherPK

Other names 1

  • Dave's Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20141009000132 NE Part B Supplier - Mass Immunization (Roster Biller Only) 3870713167 1 other NPI on this enrollment
Practice locations: Alliance, NE; Hemingford, NE
O20191216000739 NE DME Supplier - Pharmacy 3870713167 Practice locations: Hemingford, NE

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Keystone RX Corporation Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1922411925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95",
            "city": "HEMINGFORD",
            "state": "NE",
            "postal_code": "693480095",
            "telephone_number": "308-487-5212",
            "fax_number": "308-487-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 NIOBRARA AVE",
            "city": "HEMINGFORD",
            "state": "NE",
            "postal_code": "693489703",
            "telephone_number": "308-487-5212",
            "fax_number": "308-487-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE RX CORPORATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-06",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "308-760-1966"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NE",
            "license": "3016",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2146246",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dave's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dave's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hemingford, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.