Provider Demographics
NPI:1083797997
Name:WEIMER DRUG CO., INC.
Entity Type:Organization
Organization Name:WEIMER DRUG CO., INC.
Other - Org Name:PATTERSON HEALTHCARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:NOLAN
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:785-632-3115
Mailing Address - Street 1:105 NW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:KS
Mailing Address - Zip Code:67410-2628
Mailing Address - Country:US
Mailing Address - Phone:785-263-2229
Mailing Address - Fax:785-263-2547
Practice Address - Street 1:105 NW 3RD ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:KS
Practice Address - Zip Code:67410-2628
Practice Address - Country:US
Practice Address - Phone:785-263-2229
Practice Address - Fax:785-263-2547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS97043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100435180AMedicaid
KS1701350OtherNCPDP#