Provider Demographics
NPI:1265511927
Name:PROSCRIPT FAMILY PHARMACY
Entity Type:Organization
Organization Name:PROSCRIPT FAMILY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/MGR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:VINING
Authorized Official - Suffix:SR
Authorized Official - Credentials:BS PHARMACY
Authorized Official - Phone:620-331-3292
Mailing Address - Street 1:412 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KS
Mailing Address - Zip Code:67301-3517
Mailing Address - Country:US
Mailing Address - Phone:620-331-3292
Mailing Address - Fax:620-331-1925
Practice Address - Street 1:412 W MAIN ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301-3517
Practice Address - Country:US
Practice Address - Phone:620-331-3292
Practice Address - Fax:620-331-1925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSBP6807979183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty