Organization
GOODLAND MEDICAL ARTS PHARMACY LLC
Active
Organization
GOODLAND MEDICAL ARTS PHARMACY LLC
Active
Other names
GOODLAND MEDICAL ARTS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CESAR MILLER (PHARMACY MANAGER)
(785) 890-5111
Entity
Organization
Contact information
Practice address
202 WILLOW RD, GOODLAND, KS 67735-1520
(785) 890-5111
(785) 890-5111
Mailing address
202 WILLOW RD, GOODLAND, KS 67735-1520
(785) 890-5111
(785) 890-5111
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-09423
KS
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100443540A
—
KS
01
—
2030485
PK
—
Enumeration date
07/30/2006
Last updated
09/13/2016
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