Organization
MONTEZUMA DRUG LLC
Active
Parent organization
MONTEZUMA DRUG LLC
Other names
Montezuma Drug LTC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MONTEZUMA DRUG LLC
Authorized official
JAMI J HELM-MEAIRS (OWNER/PIC)
(620) 846-2202
Entity
Organization
Contact information
Practice address
300 N AZTEC ST, MONTEZUMA, KS 67867-8874
(620) 846-2202
(620) 846-7130
Mailing address
PO BOX 128, MONTEZUMA, KS 67867-0128
(620) 846-2202
(620) 846-7130
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201107230A
—
KS
Enumeration date
10/08/2019
Last updated
10/08/2019
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