Iola Pharmacy Inc
Organization Active NPI Long Term Care Pharmacy · Iola, KS
NPI 1255445235 · NPPES record last updated Jan 19, 2017
Key facts
- NPI
- 1255445235
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Long Term Care Pharmacy 3336L0003X
- License
- 209923 (KS)
- Legal business name
- IOLA PHARMACY INC
- Practice address
- 113 E Madison Ave
Iola, KS 66749-3330 - Phone
- (620) 365-5555
- Fax
- (620) 365-6722
- NPI assigned
- Aug 18, 2006
- Organization subpart
- No
Authorized official
- Name
- William Walden, RPH
- Title
- Secretary
- Phone
- (620) 365-5555
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 2
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Iola Pharmacy, Inc/Gericare LTC |
Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930080113 | KS | DME Supplier - Pharmacy | 7315064656 | Practice locations: Iola, KS |
National Provider Directory
- Tax ID family
- Iola Pharmacy Inc
Locations
113 E Madison Ave
Iola, KS 66749
Phone (620) 365-5555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Long Term Care Pharmacy | 3336L0003X | 209923 | KS | Yes |
| Managed Care Organization Pharmacy | 3336M0003X |
Addresses
Primary practice location
113 E Madison Ave
Iola, KS 66749-3330
Mailing address
109 E Madison Ave
Iola, KS 66749-3330
Phone (620) 365-5555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2027270 | Other | PK | |
| 200259940A | Medicaid | KS |
Other names
- GERICARE LTC
Other providers in Iola, KS
- Debora J Higginbotham
- Nicole Rae Hines
- Michelle A Hoag
- Richard L Hull
- Iola Pharmacy Inc
- Iola Pharmacy Inc
- Iola Pharmacy Inc.
- Iola Rehabilitation & Health Care Center LLC
- Iola Vision Source, LLC
- Autumn Irwin
All providers in Iola, KS · Long Term Care 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 Jan 19, 2017. 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.