Elmhurst Apothecary, LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

2-09818 Issued in KS

Legal business name

ELMHURST APOTHECARY, LLC

Practice address

1018 Elmhurst Blvd
Concordia, KS 66901-3900

Phone

(785) 243-9796

Fax

(785) 243-1827

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Douglas L Funk, R.PH.

Title

Member

Phone

(785) 243-9796

Specialties & licenses 1

Addresses

Other names 1

• Elmhurst Apothecary Doing business as

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679640197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 ELMHURST BLVD",
            "city": "CONCORDIA",
            "state": "KS",
            "postal_code": "669013900",
            "telephone_number": "785-243-9796",
            "fax_number": "785-243-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 ELMHURST BLVD",
            "city": "CONCORDIA",
            "state": "KS",
            "postal_code": "669013900",
            "telephone_number": "785-243-9796",
            "fax_number": "785-243-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMHURST APOTHECARY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FUNK",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "785-243-9796",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "KS",
            "license": "2-09818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elmhurst Apothecary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• County of Cloud
• County of Cloud
• Amy Crouse, LPN
• Suzanna Lu Dailey, P.T.A.
• Jonathan Dominguez
• Daniel Lynn Enns
• Brandon K Fraley, PA
• Fresh Perspectives Counseling and Consultation Services LLC
• Funk Medical & Mobility, Inc
• Daniel J Garlow, M.D.

• Compounding Pharmacy in Concordia, KS
• Providers in Concordia, KS by specialty
• Compounding Pharmacy in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.