Wolkar Drug Inc
Organization Active NPI Community/Retail Pharmacy · Baxter Springs, KS
NPI 1053423905 · NPPES record last updated Dec 13, 2021
Key facts
- NPI
- 1053423905
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 2-13206 (KS)
- Legal business name
- WOLKAR DRUG INC
- Practice address
- 1920 Military Ave
Baxter Springs, KS 66713-2039 - Phone
- (620) 856-5555
- Fax
- (620) 856-3455
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Brian Caswell, RPH
- Title
- President Pharmacist in Charge
- Phone
- (620) 856-5555
Practitioners 2
-
Brian Douglas Caswell, R.PH.
-
Megan Kathleen Sherrell, PHARMD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D2183717 | Wolkar Drug | Certificate of waiver | May 7, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211102000374 | KS | Part B Supplier - Pharmacy | 7113315722 | Practice locations: Baxter Springs, KS |
National Provider Directory
Locations
1920 Military Ave
Baxter Springs, KS 66713
Phone (620) 856-5555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 2-13206 | KS | Yes |
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
1920 Military Ave
Baxter Springs, KS 66713-2039
Mailing address
1920 Military Ave
Baxter Springs, KS 66713-2039
Phone (620) 856-5555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053423905 | Medicaid | MO | |
| 2030496 | Other | PK | |
| 600904403 | Medicaid | MO | |
| 100231810A | Medicaid | OK | |
| 100436830A | Medicaid | KS |
Other names
- WOLKAR DRUG
Other providers in Baxter Springs, KS
All providers in Baxter Springs, KS · Community/Retail Pharmacy in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.