Organization
STEVEN G CHARLES
Active
Other names
OSWEGO DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN CHARLES RPH (OWNER)
(620) 795-2233
Entity
Organization
Contact information
Practice address
413 COMMERCIAL ST, OSWEGO, KS 67356-2017
(620) 795-2233
(620) 795-4910
Mailing address
413 COMMERCIAL ST, OSWEGO, KS 67356-2017
(620) 795-2233
(620) 795-4910
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
206649
KS
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100438590A
—
KS
01
—
1711541
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/31/2006
Last updated
06/22/2011
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