Organization
AD ASTRA PHARMACY LLC
Active
Other names
Kellstrom Pharmacy, KELLSTROM PHARMACY LTC
Organization subpart
No
Provider details
NPI number
Authorized official
MILKA GOODLETT PHARM. D. (MANAGER/OWNER)
(785) 776-1200
Entity
Organization
Contact information
Practice address
1860 CLAFLIN RD, MANHATTAN, KS 66502-3413
(785) 776-1200
(785) 776-1115
Mailing address
1860 CLAFLIN RD, MANHATTAN, KS 66502
(785) 776-1200
(785) 776-1115
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
1-11676
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201261060A
—
KS
01
—
2027347
PK
—
Enumeration date
07/17/2006
Last updated
05/24/2023
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