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Organization

AR - EX DRUG STORE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. GLENDA J LOWDERMILK (SECRETARY TREASURER)
(785) 562-3196
Entity
Organization

Contact information

Practice address
801 BROADWAY, MARYSVILLE, KS 66508
(785) 562-3196
(785) 562-2340
Mailing address
801 BROADWAY, MARYSVILLE, KS 66508
(785) 562-3196
(785) 562-2340

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
207380
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100434350A
KS
05
100434360A
KS
01
1704003
NCPDC
Enumeration date
10/25/2006
Last updated
07/01/2008
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