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Organization
GATLIN FAMILY PHARMACY LLC
Active
Organization
GATLIN FAMILY PHARMACY LLC
Active
Other names
Gatlin Medical Arts Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY LYNN GATLIN RPH (OWNER/PHARMACIST)
(620) 388-1258
Entity
Organization
Contact information
Practice address
420 COUNTRY CLUB RD, PRATT, KS 67124-3125
(620) 672-7447
(620) 672-6236
Mailing address
420 COUNTRY CLUB RD, PRATT, KS 67124-3125
(620) 672-7447
(620) 672-6236
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
2-101672
KS
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201168120A
—
KS
01
—
7627490001
PTAN DMEPOS
—
01
—
KA4364
PTAN IMMUNIZATIONS
—
Enumeration date
07/12/2017
Last updated
05/19/2019
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