Organization
MULVANE PHARMACY INC
Active
Other names
MULVANE PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY RICHARDSON (PRESIDENT)
(316) 777-1601
Entity
Organization
Contact information
Practice address
1008 SE LOUIS DR, MULVANE, KS 67110-1109
(316) 777-1601
(316) 777-1693
Mailing address
1008 SE LOUIS DR, MULVANE, KS 67110-1109
(316) 777-1601
(316) 777-1693
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-09870
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00437630A
—
KS
05
—
100437630A
—
KS
01
—
2031127
PK
—
Enumeration date
10/31/2006
Last updated
11/13/2014
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