Medical Park Pharmacy of Great Bend PA

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MEDICAL PARK PHARMACY OF GREAT BEND PA

Practice address

1309 Polk
Great Bend, KS 67530-3644

Phone

(620) 792-1221

Fax

(620) 792-6413

NPI assigned

Nov 15, 2006

Last updated

Feb 20, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Lavern Regier, RPH

Title

RPH President

Phone

(620) 792-1221

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1861564437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 POLK",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303644",
            "telephone_number": "620-792-1221",
            "fax_number": "620-792-6413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 POLK",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303644",
            "telephone_number": "620-792-1221",
            "fax_number": "620-792-6413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PARK PHARMACY OF GREAT BEND PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "REGIER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "LAVERN",
        "authorized_official_title_or_position": "RPH PRESIDENT",
        "authorized_official_telephone_number": "620-792-1221",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100444470A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100444470B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Anna McLain, LPC
• Meals on Wheels of Barton County
• Med-Trans Corporation
• Med-Trans Corporation
• Medical Park Home Equipment LLC
• Medicalodges, Inc. (Medicalodges Great Bend)
• Medicalodges, Inc. (Gran Villas Great Bend)
• Angela D Meitner, COTA
• Shannon Michael Merhoff
• Jami Ann Merlau, MS, CCC-SLP

• Community/Retail Pharmacy in Great Bend, KS
• Providers in Great Bend, KS by specialty
• Community/Retail Pharmacy in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.