Organization
MONTEZUMA DRUG LLC
Active
Other names
Montezuma Drug
Organization subpart
No
Provider details
NPI number
Authorized official
JAMI HELM (OWNER/PIC)
(620) 846-2202
Entity
Organization
Contact information
Practice address
300 N AZTEC ST, MONTEZUMA, KS 67867-8874
(620) 846-2202
(620) 846-7130
Mailing address
PO BOX 128, MONTEZUMA, KS 67867-0128
(620) 846-2202
(620) 846-7130
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-13042
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201107230A
—
KS
01
—
2147191
PK
—
Enumeration date
06/25/2014
Last updated
06/24/2020
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