# MONTEZUMA DRUG LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MONTEZUMA DRUG LLC
- **Other names:** Montezuma Drug LTC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1861033185
- **Legal business name:** MONTEZUMA DRUG LLC
- **Authorized official:** JAMI J HELM-MEAIRS (OWNER/PIC)
- **Authorized official phone:** (620) 846-2202

## Contact information

- **Practice address:** 300 N AZTEC ST, MONTEZUMA, KS 67867-8874
- **Practice address phone:** (620) 846-2202
- **Practice address fax:** (620) 846-7130
- **Mailing address:** PO BOX 128, MONTEZUMA, KS 67867-0128
- **Mailing address phone:** (620) 846-2202
- **Mailing address fax:** (620) 846-7130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 10/08/2019
- **Last updated:** 10/08/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 201107230A | — | KS |