Murdock Health and Wellness Inc
Organization Active NPI Community/Retail Pharmacy · De Soto, KS
NPI 1104908995 · NPPES record last updated Nov 17, 2016
Key facts
- NPI
- 1104908995
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 2-10202 (KS)
- Legal business name
- MURDOCK HEALTH AND WELLNESS INC
- Practice address
- 34040 Commerce Dr
De Soto, KS 66018 - Phone
- (913) 583-1117
- Fax
- (913) 585-9801
- NPI assigned
- Oct 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Lori Murdock, RPH
- Title
- Owner Pic
- Phone
- (913) 583-1117
Member organizations 1
Practitioners 2
-
Lori Ann Murdock, RPH
-
Betsey Erin Gallinger, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200622000144 | KS | Part B Supplier - Pharmacy | 4880804707 | Practice locations: De Soto, KS |
National Provider Directory
Locations
34040 Commerce Dr
De Soto, KS 66018
Phone (913) 583-1117
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 2-10202 | KS | Yes |
Addresses
Primary practice location
34040 Commerce Dr
De Soto, KS 66018
Mailing address
34040 Commerce
De Soto, KS 66018
Phone (913) 583-1117
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200302720A | Medicaid | KS | |
| 200302720B | Medicaid | KS | |
| 2027327 | Other | PK |
Other names
- CEDAR CREEK PHARMACY
Other providers in De Soto, KS
- Betsey Erin Gallinger
- Matthew Edward Graunke
- Great Expectations
- Jessica Greinke
- Stephanie Rose King
- Lori Ann Murdock
- Osage Valley Healthcare LLC
- Osage Valley Healthcare LLC
- Pathways and Partnerships, Inc.
- Laura J Peek
All providers in De Soto, 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 Nov 17, 2016. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.