Downtown Drugstore LLC
Organization Active NPI Community/Retail Pharmacy · Tonganoxie, KS
NPI 1346476900 · NPPES record last updated Jun 28, 2016
Key facts
- NPI
- 1346476900
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 2-10245 (KS)
- Legal business name
- DOWNTOWN DRUGSTORE LLC
- Practice address
- 516 E 4TH St
Tonganoxie, KS 66086-8920 - Phone
- (913) 369-3800
- Fax
- (913) 369-3804
- NPI assigned
- Jun 9, 2009
- Organization subpart
- No
Authorized official
- Name
- Sarah Breuer
- Title
- Owner/Pic
- Phone
- (913) 369-3800
Practitioners 1
-
Sarah J Breuer, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210204002770 | KS | Part B Supplier - Mass Immunization (Roster Biller Only) | 6709290604 | Practice locations: Tonganoxie, KS |
National Provider Directory
Locations
516 E 4th St
Tonganoxie, KS 66086
Phone (913) 369-3800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 2-10245 | KS | Yes |
Addresses
Primary practice location
516 E 4TH St
Tonganoxie, KS 66086-8920
Mailing address
PO Box 902
Tonganoxie, KS 66086-0902
Phone (913) 369-3800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2120600 | Other | PK |
Other names
- The Downtown Drugstore LLC
Other providers in Tonganoxie, KS
- Emma Dametz
- Crystal Day
- Richard E Dean
- Elizabeth Deay-Berridge
- Amanda Derfler
- Matthew R Drake
- Molly Margaret Dumovich
- Karen Yvonne Erath
- Ez Health Medical Group Midwest PA
- Rhonda Faria
All providers in Tonganoxie, 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 Jun 28, 2016. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.