Organization
CANDLEWOOD PHARMACY, LC
Active
Other names
Candlewood Health Mart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AMY HELLERICH PHARMD (OWNER/PHARMACIST IN CHARGE)
(785) 776-4100
Entity
Organization
Contact information
Practice address
3254 KIMBALL AVE, MANHATTAN, KS 66503-2157
(785) 776-4100
(785) 776-1039
Mailing address
3254 KIMBALL AVE, MANHATTAN, KS 66503-2157
(785) 776-4100
(785) 776-1039
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
2-09136
KS
3336C0003X
Community/Retail Pharmacy
Primary
2-09136
KS
3336L0003X
Long Term Care Pharmacy
2-09136
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100325350A
—
KS
Enumeration date
09/26/2006
Last updated
10/24/2023
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