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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