Alan Duane Conrady, RPH
Individual provider Active NPI Pharmacist · Coffeyville, KS
NPI 1255425757 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1255425757
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 1-9865 (KS)
- Practice address
- 601 W 11TH St
Coffeyville, KS 67337-5025 - Phone
- (620) 251-1620
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-9865 | KS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prescription Shop, Inc | Past | Accepting new patients | |
| Prescription Shop Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 1-9865 | KS | Yes |
Addresses
Primary practice location
601 W 11TH St
Coffeyville, KS 67337-5025
Mailing address
2725 Fairway Dr
Independence, KS 67301-1613
Phone (620) 577-4221
Other providers in Coffeyville, KS
- Community Health Center of Southeast Kanas, Inc.
- Community Health Center of Southeast Kansas Inc
- Community Health Center of Southeast Kansas, Inc
- Community Health Center of Southeast Kansas, Inc.
- Jon W. Conrad
- Timothy Cosgrove
- County of Montgomery
- Cynthia Marie Dale
- Tina Daniel
- David C. Bumgarner, D.C., P.a.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.