| NPI | 1699884486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK COBERLY Pres. 620-663-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: KS 2-08103) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-08-22 |