Organization
DEGOLERS INC
Active
Other names
DeGoler Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN HARTE (PRESIDENT)
(913) 596-2447
Entity
Organization
Contact information
Practice address
202 OAK ST, BONNER SPRINGS, KS 66012-1029
(913) 422-3066
(913) 422-7050
Mailing address
111 OAK ST, BONNER SPRINGS, KS 66012-1049
(913) 422-3066
(913) 422-7050
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2-10351
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100435330H
—
KS
01
—
2131783
PK
—
Enumeration date
10/04/2006
Last updated
12/20/2013
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