Organization
MEDICAL PHARMACY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH GILLILAND PHARM. D. (OWNER)
(785) 364-2114
Entity
Organization
Contact information
Practice address
1100 COLUMBINE DR, SUITE A, HOLTON, KS 66436-8824
(785) 364-2114
Mailing address
1100 COLUMBINE DR, SUITE A, HOLTON, KS 66436-8824
(785) 364-2114
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2006003920B
—
KS
Enumeration date
09/25/2006
Last updated
08/14/2009
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