Organization
GATLIN FAMILY PHARMACY LLC
Active
Other names
Gatlin Medical Arts Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY LYNN GATLIN RPH (OWNER/PHARMACIST)
(620) 388-1258
Entity
Organization
Contact information
Practice address
420 COUNTRY CLUB RD, PRATT, KS 67124-3125
(620) 672-7447
(620) 672-6236
Mailing address
420 COUNTRY CLUB RD, PRATT, KS 67124-3125
(620) 672-7447
(620) 672-6236
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
2-101672
KS
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201168120A
—
KS
01
—
7627490001
PTAN DMEPOS
—
01
—
KA4364
PTAN IMMUNIZATIONS
—
Enumeration date
07/12/2017
Last updated
05/19/2019
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