Organization
IOLA PHARMACY INC
Active
Other names
IOLA PHARMACY CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES BAUER (OWNER)
(620) 365-9332
Entity
Organization
Contact information
Practice address
1408 EAST ST, IOLA, KS 66749-4402
(620) 365-6848
(620) 365-6849
Mailing address
109 E MADISON AVE, IOLA, KS 66749-3330
(620) 365-3176
(620) 365-5111
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
210178
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100080440H
—
KS
01
—
2027874
PK
—
Enumeration date
04/30/2008
Last updated
01/19/2017
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