| NPI | 1164516019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED HUMPERT Pharmacist 620-221-0080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KS 5083) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2010-08-05 |