Av Drug Acquisition Co

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

209463 Issued in KS

Legal business name

AV DRUG ACQUISITION CO

Doing business as

Great Plains Compounding Ctr

Practice address

11131 W 79TH St
Lenexa, KS 66214-1482

Phone

(913) 234-4664

Fax

(913) 234-4665

NPI assigned

Aug 4, 2006

Last updated

Apr 20, 2012By 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

Philip F Rellihan, RPHNPI 1811109697

Title

General Manager

Phone

(913) 234-4664

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• GREAT PLAINS COMPOUNDING CTR Doing business as

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.

• Philip Frederick Rellihan Jr., RPH

  • Pharmacist
  • Lenexa, KS
  • NPI 1811109697
  Authorized official Same address or phone

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334880000000",
    "number": "1891703914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11131 W 79TH ST",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662141482",
            "telephone_number": "913-234-4664",
            "fax_number": "913-234-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11131 W 79TH ST",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662141482",
            "telephone_number": "913-234-4664",
            "fax_number": "913-234-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AV DRUG ACQUISITION CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-04-20",
        "status": "A",
        "authorized_official_last_name": "RELLIHAN",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "913-234-4664",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "KS",
            "license": "209463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1715260",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100434000A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREAT PLAINS COMPOUNDING CTR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; 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.