Organization
MULLEN PHARMACY PA INC
Active
Other names
Grant County Drug
Organization subpart
No
Provider details
NPI number
Authorized official
TYSON MULLEN PHARM D (PHARMACIST/OWNER)
(620) 356-1446
Entity
Organization
Contact information
Practice address
219 N MAIN ST, ULYSSES, KS 67880-2130
(620) 356-1446
(620) 356-5381
Mailing address
PO BOX 570, ULYSSES, KS 67880-0570
(620) 356-1446
(620) 356-5381
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
210447
KS
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201072420A
—
KS
01
—
2140171
PK
—
Enumeration date
04/22/2013
Last updated
02/23/2017
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