Provider Demographics
NPI:1114921798
Name:WINFIELD PHARMACY, INC
Entity Type:Organization
Organization Name:WINFIELD PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAPIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-221-0450
Mailing Address - Street 1:PO BOX 756
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-0756
Mailing Address - Country:US
Mailing Address - Phone:620-221-0450
Mailing Address - Fax:620-221-7681
Practice Address - Street 1:1708 E 9TH AVE
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-3220
Practice Address - Country:US
Practice Address - Phone:620-221-0450
Practice Address - Fax:620-221-7681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2-09980183500000X
KS2-10380310400000X, 313M00000X, 314000000X, 315P00000X, 324500000X
332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No310400000XNursing & Custodial Care FacilitiesAssisted Living FacilityGroup - Single Specialty
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral NutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200532660Medicaid
KS5717770001Medicare NSC