Independence Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2-10199 Issued in KS

Legal business name

INDEPENDENCE PHARMACY

Doing business as

Independence Pharmacy

Practice address

205 N Penn Ave
Independence, KS 67301-3323

Phone

(620) 331-3784

Fax

(620) 331-1701

NPI assigned

Aug 14, 2008

Organization subpart

No

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

Authorized official

Name

Terry L. Scott

Title

Pres

Phone

(620) 331-3784

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Independence Pharmacy Doing business as

Practitioners 2

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

• Michelle R Blankenship, RPH

  • Pharmacist
  • Independence, KS
  • NPI 1336287358
  NPD (past)
• Sarah Denise-Bradburn Nordt, PHARMD

  • Pharmacist
  • Independence, KS
  • NPI 1386134880
  NPD (past)

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575936000000",
    "number": "1962658633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N PENN AVE",
            "address_2": "PO BOX 71",
            "city": "INDEPENDENCE",
            "state": "KS",
            "postal_code": "673013323",
            "telephone_number": "620-331-3784",
            "fax_number": "620-331-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N PENN AVE",
            "city": "INDEPENDENCE",
            "state": "KS",
            "postal_code": "673013323",
            "telephone_number": "620-331-3784",
            "fax_number": "620-331-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-14",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "620-331-3784"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KS",
            "license": "2-10199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200568190A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200568190B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2116608",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Independence Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Independence Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tessie Grace Horning, LMLP
• Cassie Nicolette Houf, LCSW
• Baylee Marie Huntsinger, LMSW
• Icare Optometry, P.a.
• Independence Dental, LLC
• Marie Elaine Ingram, LSCSW
• Lori Diane Isle, MSN, FNP, APRN-C
• Abdi Issack, PHARMD
• Rachel Ann Jamison
• Jane Phillips Memorial Medical Center, Inc

• Community/Retail Pharmacy in Independence, KS
• Providers in Independence, 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 Dec 10, 2019; 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.