Active NPI
Eric Bosley
- Pharmacist
- Great Bend, KS
National Provider Identifier
1104319904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 1-11783
- Practice address
- 3503 10TH St
Great Bend, KS 67530-3538 - Phone
- (620) 792-5237
- NPI assigned
- Jun 7, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 1-11783 | KS | Primary |
Addresses
Primary practice location
3503 10TH St
Great Bend, KS 67530-3538
Mailing address
3503 10TH St
Great Bend, KS 67530-3538
Phone (316) 792-5237
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0 | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-11783 | KS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666051200000",
"number": "1104319904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3503 10TH ST",
"city": "GREAT BEND",
"state": "KS",
"postal_code": "675303538",
"telephone_number": "316-792-5237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3503 10TH ST",
"city": "GREAT BEND",
"state": "KS",
"postal_code": "675303538",
"telephone_number": "620-792-5237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSLEY",
"first_name": "ERIC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-07",
"last_updated": "2022-10-18",
"certification_date": "2022-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KS",
"license": "1-11783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Bend, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.