Provider Demographics
NPI:1194833947
Name:MARION PHARMACY INC.
Entity Type:Organization
Organization Name:MARION PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MARLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:620-382-2135
Mailing Address - Street 1:217 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:KS
Mailing Address - Zip Code:66861-1627
Mailing Address - Country:US
Mailing Address - Phone:620-382-2135
Mailing Address - Fax:620-382-3263
Practice Address - Street 1:217 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:KS
Practice Address - Zip Code:66861-1627
Practice Address - Country:US
Practice Address - Phone:620-382-2135
Practice Address - Fax:620-382-3263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2-06552332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0383330001Medicare ID - Type Unspecified