Individual
ROA A ABABNEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
458 N BALTIMORE AVE, DERBY, KS 67037-1606
(316) 788-4317
Mailing address
458 N BALTIMORE AVE, DERBY, KS 67037-1606
(316) 788-4317
(316) 788-6859
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-109974
KS
Other
Enumeration date
08/16/2020
Last updated
08/16/2020
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