Provider Demographics
NPI:1285233361
Name:LANGENEGGER, SETH JOEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:JOEL
Last Name:LANGENEGGER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 E PRICE ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-3444
Mailing Address - Country:US
Mailing Address - Phone:620-937-9397
Mailing Address - Fax:
Practice Address - Street 1:1211 BUFFALO JONES AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-4833
Practice Address - Country:US
Practice Address - Phone:620-275-0194
Practice Address - Fax:620-272-8219
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-1062921835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist