Provider Demographics
NPI:1043470396
Name:K AND D PHARMACY LLC
Entity Type:Organization
Organization Name:K AND D PHARMACY LLC
Other - Org Name:K AND D PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHCY OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-660-2497
Mailing Address - Street 1:224 SOUTH SUMMIT
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005
Mailing Address - Country:US
Mailing Address - Phone:620-307-6264
Mailing Address - Fax:620-307-6416
Practice Address - Street 1:224 S SUMMIT ST
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-2847
Practice Address - Country:US
Practice Address - Phone:620-307-6264
Practice Address - Fax:620-307-6416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
KS2-101873336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2027878OtherPK