Organization
COUNCIL GROVE PHARMACY INC
Active
Other names
The Apothecary LTC
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB EDWARDS (OWNER)
(620) 767-6731
Entity
Organization
Contact information
Practice address
123 W MAIN ST, COUNCIL GROVE, KS 66846-1702
(620) 767-6731
(620) 767-6858
Mailing address
123 W MAIN ST, COUNCIL GROVE, KS 66846-1702
(620) 767-6731
(620) 767-6858
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
03/05/2024
Last updated
03/05/2024
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