Organization
C & R CLINIC PHARMACY INC. OF ELKHART
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY L SCOTT RPH (OWNER/PHARMACIST IN CHARGE)
(620) 697-2131
Entity
Organization
Contact information
Practice address
411 SUNSET DRIVE, ELKHART, KS 67950-0962
(620) 697-2131
(620) 697-4643
Mailing address
PO BOX 962, ELKHART, KS 67950-0962
(620) 697-2131
(620) 697-4643
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6590
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100245910A
—
OK
05
—
100438580A
—
KS
01
—
1710640
NCPDP PHARMACY NUMBER
—
05
—
93725248
—
CO
Enumeration date
02/22/2006
Last updated
03/05/2008
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