Organization
HAYSVILLE HEALTHMART PHARMACY LLC
Active
Other names
HAYSVILLE HEALTH MART PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AMR ABUALNADI RPH (PIC AND OWNER)
(316) 524-4234
Entity
Organization
Contact information
Practice address
145 N MAIN ST, HAYSVILLE, KS 67060-1202
(316) 524-4234
(316) 524-1630
Mailing address
145 N MAIN ST, HAYSVILLE, KS 67060-1202
(316) 524-4234
(316) 524-1630
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-06945
KS
3336S0011X
Specialty Pharmacy
2-13149
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100438770A
—
KS
01
—
1712606
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/23/2007
Last updated
03/04/2016
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