Organization
KANSAS PHARMACY LLC
Active
Other names
Kansas Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
P. ANDREW TURNER (MEMBER)
(918) 543-8777
Entity
Organization
Contact information
Practice address
1119 E TULSA AVE, KANSAS, OK 74347-7055
(918) 868-6162
(918) 868-6167
Mailing address
PO BOX 700, INOLA, OK 74036-0700
(918) 543-8777
(918) 543-2013
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
45-6072
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200458760A
—
OK
01
—
2136938
PK
—
Enumeration date
09/27/2012
Last updated
05/02/2016
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