Ad Astra Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

1-11676 Issued in KS

Legal business name

AD ASTRA PHARMACY LLC

Doing business as

Kellstrom Pharmacy LTC
Kellstrom Pharmacy

Practice address

1860 Claflin Rd
Manhattan, KS 66502-3413

Phone

(785) 776-1200

Fax

(785) 776-1115

NPI assigned

Jul 17, 2006

Last updated

May 24, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Milka Goodlett, PHARM. D.NPI 1316580269

Title

Manager/Owner

Phone

(785) 776-1200

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 2

• KELLSTROM PHARMACY LTC Doing business as
• Kellstrom Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Ad Astra Pharmacy LLC

  dba Kellstrom Pharmacy

  • Community/Retail Pharmacy
  • Manhattan, KS
  • NPI 1144253378

  O20230524003400

  Same enrollment

Tax ID family

Ad Astra Pharmacy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ad Astra Pharmacy LLC

  dba Kellstrom Pharmacy

  • Community/Retail Pharmacy
  • Manhattan, KS
  • NPI 1144253378
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Milka Goodlett, PHARM. D.

  • Pharmacist
  • Manhattan, KS
  • NPI 1316580269
  NPD Authorized official

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1144247651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 CLAFLIN RD",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "66502",
            "telephone_number": "785-776-1200",
            "fax_number": "785-776-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 CLAFLIN RD",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665023413",
            "telephone_number": "785-776-1200",
            "fax_number": "785-776-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AD ASTRA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "GOODLETT",
        "authorized_official_first_name": "MILKA",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "785-776-1200",
        "authorized_official_credential": "PHARM. D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "KS",
            "license": "1-11676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201261060A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2027347",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KELLSTROM PHARMACY LTC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KELLSTROM PHARMACY LTC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kellstrom Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Manhattan, KS
• Providers in Manhattan, KS by specialty
• Long Term Care Pharmacy in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.