Fredonia Pharmacy
LBN: Fredonia Pharmacy Inc
Fredonia Pharmacy is an health care organization with primary practice located at 628 Madison St , Fredonia KS 66736-1338. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Fredonia Pharmacy Inc can be contacted via phone (620) 378-4422, or through Edwards, Jacob via phone (620) 378-4422.
Contact Information
Primary practice address
628 Madison St
Fredonia KS 66736-1338
Phone: (620) 378-4422
Fax: (620) 378-2586
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 207947 | Kansas |
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1942312897 |
|---|---|
| LBN Legal business name | Fredonia Pharmacy Inc |
| DBA Doing business as | Fredonia Pharmacy |
| Authorized official | Edwards, Jacob |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Jan 16th, 2024 - about 10 months ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942312897 | NPPES |
| Kansas | MEDICAID | 100439810A | |
| Kansas | Other | 2032337 |
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