Organization
JSW, LLC
Active
Other names
Greeley County Drug, dixon drug
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMI WHITHAM (OWNER)
(620) 376-4224
Entity
Organization
Contact information
Practice address
422 BROADWAY, TRIBUNE, KS 67879
(620) 376-4224
Mailing address
PO BOX 238, TRIBUNE, KS 67879-0238
(620) 376-4224
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
207357
KS
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100438980A
—
KS
Enumeration date
07/21/2006
Last updated
01/14/2023
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