Organization
SAINT-MARK ENTERPRISES 1196 LLC
Active
Organization
SAINT-MARK ENTERPRISES 1196 LLC
Active
Other names
The Medicine Shoppe Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RIK ST GERMAIN (OWNER)
(206) 650-5514
Entity
Organization
Contact information
Practice address
1000 ADAMS ST, GREAT BEND, KS 67530-4208
(620) 792-3030
(620) 792-4971
Mailing address
1070 VIA SAINT LUCIA PL, HENDERSON, NV 89011-0873
(206) 650-5541
(702) 568-8676
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-10424
KS
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2137647
PK
—
Enumeration date
09/25/2012
Last updated
11/07/2016
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