Organization
VOLLERTSEN CORPORATION
Active
Other names
MOFFET DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN VOLLERTSEN (OWNER PHARMACIST)
(785) 877-2721
Entity
Organization
Contact information
Practice address
102 S STATE ST, NORTON, KS 67654-2142
(785) 877-2721
(785) 877-2721
Mailing address
PO BOX 405, NORTON, KS 67654-0405
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
208413
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100434760A
—
KS
01
—
1704332
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/23/2006
Last updated
09/29/2011
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