Blade Thomas Kalleck, PHARMD, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

1-107224 Issued in KS

Practice address

300 State St
Phillipsburg, KS 67661-1930

Phone

(785) 543-5131

Fax

(785) 543-5844

NPI assigned

Sep 16, 2022

Last updated

Sep 16, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy, Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Midwest Family Health of Phillipsburg Inc

  dba Midwest Family Health

  • Community/Retail Pharmacy
  • Phillipsburg, KS
  • NPI 1144263310
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1043932890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 STATE ST",
            "city": "PHILLIPSBURG",
            "state": "KS",
            "postal_code": "676611930",
            "telephone_number": "785-543-5131",
            "fax_number": "785-543-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STATE ST",
            "city": "PHILLIPSBURG",
            "state": "KS",
            "postal_code": "676611930",
            "telephone_number": "785-543-5131",
            "fax_number": "785-543-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLECK",
        "first_name": "BLADE",
        "middle_name": "THOMAS",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-107224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Phillipsburg, KS
• Providers in Phillipsburg, KS by specialty
• Pharmacist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.