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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