NPIMap

Organization Active NPI

Fredonia Pharmacy Inc

Doing business as Fredonia Pharmacy LTC

  • Long Term Care Pharmacy
  • Fredonia, KS
National Provider Identifier
1366200586
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
FREDONIA PHARMACY INC
Doing business as
Fredonia Pharmacy LTC
Practice address
628 Madison St
Fredonia, KS 66736-1338
Phone
(620) 378-4422
NPI assigned
Mar 12, 2024
Last updated
Jul 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Authorized official

Name
Lance Michael Freeman
Title
President
Phone
(620) 378-4422

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X Primary
Specialty Pharmacy 3336S0011X
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

628 Madison St
Fredonia, KS 66736-1338

Mailing address

628 Madison St
Fredonia, KS 66736-1338

Other names 1

  • Fredonia Pharmacy LTC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fredonia Healthmart Phar2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1710201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784246400000",
    "number": "1366200586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 MADISON ST",
            "city": "FREDONIA",
            "state": "KS",
            "postal_code": "667361338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 MADISON ST",
            "city": "FREDONIA",
            "state": "KS",
            "postal_code": "667361338",
            "telephone_number": "620-378-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDONIA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-12",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "620-378-4422"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fredonia Pharmacy LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fredonia, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.