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Organization
MAHONEYS COMPOUNDING PHARMACY LLC
Active
Organization
MAHONEYS COMPOUNDING PHARMACY LLC
Active
Other names
MAHONEY'S COMPOUNDING PHARMACY, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SAM MAHONEY BS PHARMACY (PRESIDENT)
(913) 956-7711
Entity
Organization
Contact information
Practice address
11844 QUIVIRA RD, OVERLAND PARK, KS 66210-1300
(913) 956-7711
(913) 956-7722
Mailing address
11844 QUIVIRA RD, OVERLAND PARK, KS 66210-1300
(913) 956-7711
(913) 956-7722
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
2-07293
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100438960A
—
KS
01
—
2032533
PK
—
Enumeration date
10/12/2006
Last updated
06/20/2016
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