Provider Demographics
NPI:1043077225
Name:LEEKER'S HAYSVILLE, LLC
Entity Type:Organization
Organization Name:LEEKER'S HAYSVILLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAND
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:316-744-3948
Mailing Address - Street 1:201 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAYSVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67060-1204
Mailing Address - Country:US
Mailing Address - Phone:316-522-5583
Mailing Address - Fax:316-524-4197
Practice Address - Street 1:201 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HAYSVILLE
Practice Address - State:KS
Practice Address - Zip Code:67060-1204
Practice Address - Country:US
Practice Address - Phone:316-522-5583
Practice Address - Fax:316-524-4197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy