Organization
MAINSTREET DRUG PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLENE HELLER (PHRMD)
(785) 346-2136
Entity
Organization
Contact information
Practice address
103 W MAIN ST, OSBORNE, KS 67473-2402
(785) 346-2136
(785) 346-5898
Mailing address
103 W MAIN ST, OSBORNE, KS 67473-2402
(785) 346-2136
(785) 346-5898
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
210144
KS
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2027814
PK
—
Enumeration date
09/27/2007
Last updated
10/02/2024
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