Organization Active NPI

Graves Drug Store Emporia Inc

  • Community/Retail Pharmacy
  • Emporia, KS
National Provider Identifier
1871527192
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2-08035 Issued in KS
Legal business name
GRAVES DRUG STORE EMPORIA INC
Practice address
609 Commercial St
Emporia, KS 66801-3901
Phone
(620) 343-2323
Fax
(620) 343-2663
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John P Kollhoff, PHARMD
Title
Pharmacist/Owner
Phone
(620) 343-2323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 2-08035 KS Primary

Addresses

Primary practice location

609 Commercial St
Emporia, KS 66801-3901

Mailing address

609 Commercial St
Emporia, KS 66801-3901
Phone (620) 343-2323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170802002990 KS Part B Supplier - Mass Immunization (Roster Biller Only) 9830216290 Practice locations: Emporia, KS

National Provider Directory

National Provider Directory

Locations

609 Commercial St
Emporia, KS 66801
Phone (620) 343-2323

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871527192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 COMMERCIAL ST",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668013901",
            "telephone_number": "620-343-2323",
            "fax_number": "620-343-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 COMMERCIAL ST",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668013901",
            "telephone_number": "620-343-2323",
            "fax_number": "620-343-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAVES DRUG STORE EMPORIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOLLHOFF",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "620-343-2323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KS",
            "license": "2-08035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emporia, KS

Sources for this page

  • 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.
  • 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.