Organization
GEORGETOWN HEALTH CARE CENTER, INC.
Active
Organization
GEORGETOWN HEALTH CARE CENTER, INC.
Active
Other names
Georgetown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS WALL HENDERSHOT R.PH. (PRESIDENT)
(913) 362-0313
Entity
Organization
Contact information
Practice address
5605 MERRIAM DR, MERRIAM, KS 66203-2521
(913) 362-0313
(913) 722-1600
Mailing address
5605 MERRIAM DR, MERRIAM, KS 66203-2521
(913) 362-0313
(913) 722-1600
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
2-10027
KS
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
2-10027
KS
332BX2000X
Oxygen Equipment & Supplies (DME)
2-10027
KS
3336C0003X
Community/Retail Pharmacy
Primary
2-10027
KS
3336C0004X
Compounding Pharmacy
2-10027
KS
335E00000X
Prosthetic/Orthotic Supplier
2-10027
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100436590A
—
KS
01
—
1700978
NABP
KS
Enumeration date
09/20/2006
Last updated
03/07/2023
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