Kansas Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

45-6072 Issued in OK

Legal business name

KANSAS PHARMACY LLC

Doing business as

Kansas Pharmacy

Practice address

1119 E Tulsa Ave
Kansas, OK 74347-7055

Phone

(918) 868-6162

Fax

(918) 868-6167

NPI assigned

Sep 27, 2012

Last updated

May 2, 2016By 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

P. Andrew Turner

Title

Member

Phone

(918) 543-8777

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Kansas Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

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.

• Tristan Wilson

  • Pharmacist
  • Kansas, OK
  • NPI 1083184162
  NPD (past)

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462147200000",
    "number": "1861743130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 700",
            "city": "INOLA",
            "state": "OK",
            "postal_code": "740360700",
            "telephone_number": "918-543-8777",
            "fax_number": "918-543-2013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 E TULSA AVE",
            "city": "KANSAS",
            "state": "OK",
            "postal_code": "743477055",
            "telephone_number": "918-868-6162",
            "fax_number": "918-868-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANSAS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-27",
        "last_updated": "2016-05-02",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "P. ANDREW",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "918-543-8777"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "45-6072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136938",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200458760A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kansas Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Grand Lake Mental Health Center, Inc. (GRAND Mental Health)
• Leslie Gregory
• Stacy Johnson, MSN, APRN, FNP-C
• Kansas Public Schools
• Ranae Luper
• Catherine Shanon Maddan, LMSW-P U/S
• Molly Martin, MD
• Sandra Pauline Mills, CNM

• Community/Retail Pharmacy in Kansas, OK
• Providers in Kansas, OK by specialty
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.