NPIMap

Organization Active NPI

Minneola Pharmacy II LLC

Doing business as Minneola Pharmacy

  • Long Term Care Pharmacy
  • Minneola, KS
National Provider Identifier
1508324021
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
MINNEOLA PHARMACY II LLC
Doing business as
Minneola Pharmacy
Practice address
131 S. Main St.
Minneola, KS 67865-0460
Phone
(620) 885-4544
Fax
(620) 885-4723
NPI assigned
Mar 4, 2019
Last updated
May 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Authorized official

Name
Dr. Jan R Granados, PHARMD, MPHNPI 1891708509
Title
Manager/Member
Phone
(620) 885-4544

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X NU Primary

Addresses

Primary practice location

131 S. Main St.
Minneola, KS 67865-0460

Mailing address

PO Box 460
Minneola, KS 67865-0460
Phone (620) 885-4544

Other identifiers 2

IdentifierTypeStateIssuer
1447353503OtherKSNPI
201318470AMedicaidKS

Other names 1

  • Minneola Pharmacy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1551657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620691200000",
    "number": "1508324021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 460",
            "city": "MINNEOLA",
            "state": "KS",
            "postal_code": "678650460",
            "telephone_number": "620-885-4544",
            "fax_number": "620-885-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 S. MAIN ST.",
            "city": "MINNEOLA",
            "state": "KS",
            "postal_code": "678650460",
            "telephone_number": "620-885-4544",
            "fax_number": "620-885-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNEOLA PHARMACY II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-04",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A",
        "authorized_official_last_name": "GRANADOS",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGER/MEMBER",
        "authorized_official_telephone_number": "620-885-4544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD, MPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1447353503",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201318470A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minneola Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneola, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.