| NPI | 1063868883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN BOMBARDIER Pharmacist 785-614-3492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: KS 2-101620) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2018-03-27 |