Organization
EL DORADO PHARMACY INC
Active
Other names
EL DORADO TRUECARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BELLESINE (OWNER/PHARMACIST IN CHARGE)
(316) 321-5330
Entity
Organization
Contact information
Practice address
205 N VINE ST, EL DORADO, KS 67042-2055
(316) 321-5330
(316) 321-1254
Mailing address
205 N VINE ST, EL DORADO, KS 67042-2055
(316) 321-5330
(316) 321-1254
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
209578
KS
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100444860
—
KS
01
—
2030748
PK
—
Enumeration date
04/28/2006
Last updated
02/20/2017
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