Organization
MAHONEYS COMPOUNDING PHARMACY LLC
Active
Other names
MAHONEY'S COMPOUNDING PHARMACY, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SAM MAHONEY BS PHARMACY (PRESIDENT)
(913) 956-7711
Entity
Organization
Contact information
Practice address
11844 QUIVIRA RD, OVERLAND PARK, KS 66210-1300
(913) 956-7711
(913) 956-7722
Mailing address
11844 QUIVIRA RD, OVERLAND PARK, KS 66210-1300
(913) 956-7711
(913) 956-7722
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
2-07293
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100438960A
—
KS
01
—
2032533
PK
—
Enumeration date
10/12/2006
Last updated
06/20/2016
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