JSW, LLC
Organization Active NPI Community/Retail Pharmacy · Syracuse, KS
NPI 1285682153 · NPPES record last updated Jan 13, 2023
Key facts
- NPI
- 1285682153
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 2-13076 (KS)
- Legal business name
- JSW, LLC
- Practice address
- 302 E Avenue a
Syracuse, KS 67878-7098 - Phone
- (620) 384-7424
- Fax
- (620) 384-7424
- NPI assigned
- May 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Jeremi Whitham
- Title
- Owner
- Phone
- (620) 376-4224
Corporate family (same tax ID) 2
Practitioners 2
-
David Todd Traylor, PHARMD, RPH
National Provider Directory
- Tax ID family
- Dixon Drug
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 2-13076 | KS | Yes |
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
302 E Avenue a
Syracuse, KS 67878-7098
Mailing address
PO Box 238
Tribune, KS 67879-0238
Phone (620) 384-7424
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100445530B | Medicaid | KS | |
| 62330888 | Medicaid | CO | |
| 2149448 | Other | PK |
Other names
- Hamilton County Drug
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- Marshall Ray Kenoyer
- William J Lewis
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- Tyler J. Stephenson
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All providers in Syracuse, 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 Jan 13, 2023. 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.