Haysville Healthmart Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2-06945 Issued in KS

Legal business name

HAYSVILLE HEALTHMART PHARMACY LLC

Practice address

145 N Main St
Haysville, KS 67060-1202

Phone

(316) 524-4234

Fax

(316) 524-1630

NPI assigned

Mar 23, 2007

Organization subpart

No

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

Authorized official

Name

Amr Abualnadi, RPH

Title

Pic and Owner

Phone

(316) 524-4234

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• HAYSVILLE HEALTH MART PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457049600000",
    "number": "1821115296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 N MAIN ST",
            "city": "HAYSVILLE",
            "state": "KS",
            "postal_code": "670601202",
            "telephone_number": "316-524-4234",
            "fax_number": "316-524-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 N MAIN ST",
            "city": "HAYSVILLE",
            "state": "KS",
            "postal_code": "670601202",
            "telephone_number": "316-524-4234",
            "fax_number": "316-524-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAYSVILLE HEALTHMART PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2016-03-04",
        "status": "A",
        "authorized_official_last_name": "ABUALNADI",
        "authorized_official_first_name": "AMR",
        "authorized_official_title_or_position": "PIC AND OWNER",
        "authorized_official_telephone_number": "316-524-4234",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KS",
            "license": "2-06945",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "KS",
            "license": "2-13149",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100438770A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1712606",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HAYSVILLE HEALTH MART PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Haysville, KS
• Community/Retail Pharmacy in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; 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.