Organization
GRAVES DRUG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRED HUMPERT (PHARMACIST)
(620) 221-0080
Entity
Organization
Contact information
Practice address
905 MAIN ST, WINFIELD, KS 67156-3604
(620) 221-0080
(620) 221-4383
Mailing address
905 MAIN ST, WINFIELD, KS 67156-3604
(620) 221-0080
(620) 221-4383
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5083
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100435690A
—
KS
Enumeration date
10/03/2006
Last updated
08/05/2010
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