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Organization

HODGEMAN COUNTY PHARMACY LLC

Active
Other names
Hodgeman County Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES COAST (RPH)
(620) 855-2055
Entity
Organization

Contact information

Practice address
519 MAIN STREET, JETMORE, KS 67854
(620) 357-8305
(620) 855-2052
Mailing address
PO BOX 782, CIMARRON, KS 67835-0782
(620) 855-2055
(620) 855-2052

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
2-100543
KS
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201138190A
KS
01
2162209
PK
Enumeration date
07/27/2016
Last updated
10/19/2016
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