Individual
DR. BRIAN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
909 E CENTENNIAL DR, PITTSBURG, KS 66762-6601
(620) 231-8130
(620) 231-0524
Mailing address
909 E CENTENNIAL DR, PITTSBURG, KS 66762-6601
(620) 231-8130
(620) 231-0524
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12499
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12499
KS BOARD OF PHARMACY
KS
Enumeration date
03/04/2008
Last updated
03/04/2008
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