Organization
RICKS PHARMACY AND WELLNESS INC
Active
Other names
THE MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK TEJEDA RPH (PRESIDENT OWNER)
(316) 838-2100
Entity
Organization
Contact information
Practice address
2315 W 21ST ST N, SUITE 117, WICHITA, KS 67203-2150
(316) 838-2100
(316) 838-7843
Mailing address
2315 W 21ST ST N, SUITE 117, WICHITA, KS 67203-2150
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
210043
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100440100B
—
KS
01
—
1715359
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/21/2006
Last updated
09/12/2008
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