Organization
LYON PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE FREEMAN (CO-OWNER)
(620) 509-2169
Entity
Organization
Contact information
Practice address
921 W MAIN ST, LYONS, KS 67554-1708
(620) 509-2169
(620) 509-2184
Mailing address
PO BOX 167, LYONS, KS 67554-0167
(620) 509-2169
(620) 509-2184
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2-108251
KANSAS STATE BOARD OF PHARMACY
KS
Enumeration date
12/18/2018
Last updated
10/22/2021
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