Provider Demographics
NPI:1093818056
Name:SENIOR CARE SERVICES INC
Entity Type:Organization
Organization Name:SENIOR CARE SERVICES INC
Other - Org Name:SENIOR CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEKER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:316-945-7455
Mailing Address - Street 1:1402 S RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-2908
Mailing Address - Country:US
Mailing Address - Phone:316-945-7455
Mailing Address - Fax:316-945-7457
Practice Address - Street 1:1402 S RIDGE RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-2908
Practice Address - Country:US
Practice Address - Phone:316-945-7455
Practice Address - Fax:316-945-7457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
KS2-103153336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2027083OtherPK
KS100459190AMedicaid
2027083OtherPK