Organization
GRIPKA PHARMACY LLC
Active
Other names
The Medicine Store
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY GRIPKA PHARMD (PHARMD/OWNER)
(913) 724-3666
Entity
Organization
Contact information
Practice address
15415 PINEHURST DR, BASEHOR, KS 66007-8237
(913) 724-3666
(913) 724-3667
Mailing address
15415 PINEHURST DR, BASEHOR, KS 66007-8237
(913) 724-3666
(913) 724-3667
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-10403
KS
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200879480A
—
KS
01
—
2136127
PK
—
Enumeration date
10/09/2008
Last updated
04/24/2017
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