Dep,Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2-08392 Issued in KS

Legal business name

DEP,INC.

Practice address

2409 N Broadway St
Pittsburg, KS 66762-2618

Phone

(620) 231-3410

Fax

(620) 231-3810

NPI assigned

Nov 30, 2006

Organization subpart

Yes

Parent organization

DEP, INCAs reported in NPPES

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

Authorized official

Name

Mrs. Evelyn Pistole

Title

Owner

Phone

(620) 231-3410

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• The Medicine Shoppe #1293 Doing business as

Part of

Dep Inc

Locations

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281916800000",
    "number": "1326116302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 N BROADWAY ST",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667622618",
            "telephone_number": "620-231-3410",
            "fax_number": "620-231-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 N BROADWAY ST",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667622618",
            "telephone_number": "620-231-3410",
            "fax_number": "620-231-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEP,INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEP, INC",
        "enumeration_date": "2006-11-30",
        "last_updated": "2010-08-16",
        "status": "A",
        "authorized_official_last_name": "PISTOLE",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "620-231-3410",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KS",
            "license": "2-08392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1704825",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100445440A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "608257309",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Shoppe #1293",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Janna S Debruler, LPC, CADCI
• Emily Dechant
• Logan Thayer Deems, LCPC
• Eric Benjamin Delman, D.O.
• Anagha Ashok Deole, OTR L
• Connie Dewitt, LAC
• Kamryn Paige Dials
• Anita Celeste Dickens, L.C.S.W.
• Dillon Companies LLC
• Uyen Thi Tu Dinh, PMHNP

• Community/Retail Pharmacy in Pittsburg, KS
• Providers in Pittsburg, KS by specialty
• Community/Retail Pharmacy in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.