Kiowa County Pharmacy LLC
Organization Active NPI Community/Retail Pharmacy · Greensburg, KS
NPI 1487937983 · NPPES record last updated Sep 2, 2025
Key facts
- NPI
- 1487937983
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- KIOWA COUNTY PHARMACY LLC
- Practice address
- 112 S Main St
Greensburg, KS 67054-1724 - Phone
- (620) 723-3112
- Fax
- (620) 723-3421
- NPI assigned
- Sep 21, 2011
- Organization subpart
- No
Authorized official
- Name
- Julie Keeton, PHARMD
- Title
- Owner
- Phone
- (620) 723-3112
Corporate family (same tax ID) 1
Practitioners 2
-
Julie Keeton, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171018002504 | KS | DME Supplier - Pharmacy | 0244506236 | Practice locations: Greensburg, KS |
| O20240723003197 | KS | Part B Supplier - Pharmacy | 0244506236 | Practice locations: Greensburg, KS |
National Provider Directory
- Tax ID family
- Kiowa County Pharmacy LLC
Locations
112 S Main St
Greensburg, KS 67054
Phone (620) 723-3112
721 W Kansas Ave
#101
Greensburg, KS 67054
Phone (620) 723-3112
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
112 S Main St
Greensburg, KS 67054-1724
Mailing address
112 S Main St
Greensburg, KS 67054-1724
Phone (620) 723-3112
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201147080A | Medicaid | KS | |
| 1720312 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names
- Kiowa County Pharmacy
Other providers in Greensburg, KS
- Kiowa County Memorial Hospital
- Kiowa County Memorial Hospital
- Kiowa County Memorial Hospital
- Kiowa County Memorial Hospital
- Kiowa County Memorial Hospital
- Kiowa County Pharmacy LLC
- Jacci Rae Koerner
- Brenda Marlene Marquez
- Cathy Ann Martinez
- Josh Charles Moulin
All providers in Greensburg, 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 Sep 2, 2025. 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.