Organization
FOUR B CORP
Active
Other names
HEN HOUSE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MARTIN (3RD PARTY ADMIN)
(913) 573-1294
Entity
Organization
Contact information
Practice address
6450 SPRINT PKWY, OVERLAND PARK, KS 66251-6105
(913) 315-8646
(913) 315-0653
Mailing address
6450 SPRINT PKWY, OVERLAND PARK, KS 66251-6105
(913) 315-8646
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
9650
KS
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100439480A
—
KS
05
—
100439480B
—
KS
01
—
1717593
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/20/2006
Last updated
10/10/2008
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