Organization
AD ASTRA PHARMACY LLC
Active
Other names
KELLSTROM PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MILKA GOODLETT (MANAGER/OWNER)
(785) 776-1200
Entity
Organization
Contact information
Practice address
1860 CLAFLIN ROAD, MANHATTAN, KS 66502-3492
(785) 776-1200
(785) 776-1115
Mailing address
1860 CLAFLIN ROAD, MANHATTAN, KS 66502
(785) 776-1200
(785) 776-1115
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
8034
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100437570A
—
KS
01
—
100437570B
DME
KS
01
—
1708443
NABP
—
Enumeration date
07/09/2006
Last updated
05/24/2023
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