Organization
CENTRE PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL R. WAGNER R.PH. (PIC OWNER,MGR.)
(785) 282-6933
Entity
Organization
Contact information
Practice address
114 S MAIN ST, SMITH CENTER, KS 66967-2606
(785) 282-6933
(785) 282-3550
Mailing address
114 S MAIN ST, SMITH CENTER, KS 66967-2606
(785) 282-6933
(785) 282-3550
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
KS
3336C0003X
Community/Retail Pharmacy
Primary
2-07023
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100443860A
—
KS
Enumeration date
09/27/2006
Last updated
06/17/2008
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