# AV DRUG ACQUISITION CO

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GREAT PLAINS COMPOUNDING CTR
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891703914
- **Authorized official:** PHILIP F RELLIHAN RPH (GENERAL MANAGER)
- **Authorized official phone:** (913) 234-4664

## Contact information

- **Practice address:** 11131 W 79TH ST, LENEXA, KS 66214-1482
- **Practice address phone:** (913) 234-4664
- **Practice address fax:** (913) 234-4665
- **Mailing address:** 11131 W 79TH ST, LENEXA, KS 66214-1482
- **Mailing address phone:** (913) 234-4664
- **Mailing address fax:** (913) 234-4665

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336H0001X | Home Infusion Therapy Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 209463 | KS | Yes |

## Other

- **Enumeration date:** 08/04/2006
- **Last updated:** 04/20/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100434000A | — | KS |
| 01 | — | 1715260 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |