Organization
FREEMAN PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE FREEMAN (MANAGER)
(620) 886-5161
Entity
Organization
Contact information
Practice address
530 MAIN ST, KIOWA, KS 67070-1406
(620) 825-4782
(620) 825-4562
Mailing address
530 MAIN ST, KIOWA, KS 67070-1406
(620) 825-4782
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-12997
KS
3336C0004X
Compounding Pharmacy
—
—
3336I0012X
Institutional Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200859750E
—
KS
01
—
2141967
PK
—
Enumeration date
08/27/2013
Last updated
08/02/2023
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