Organization
JSW, LLC
Active
Other names
Hamilton County Drug
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMI WHITHAM (OWNER)
(620) 376-4224
Entity
Organization
Contact information
Practice address
302 E AVENUE A, SYRACUSE, KS 67878-7098
(620) 384-7424
(620) 384-7424
Mailing address
PO BOX 238, TRIBUNE, KS 67879-0238
(620) 384-7424
(620) 384-7525
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-13076
KS
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100445530B
—
KS
01
—
2149448
PK
—
05
—
62330888
—
CO
Enumeration date
05/04/2006
Last updated
01/13/2023
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