Provider Demographics
NPI:1306840855
Name:WEIMER DRUG CO., INC.
Entity Type:Organization
Organization Name:WEIMER DRUG CO., INC.
Other - Org Name:PATTERSON HEALTH MART PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:NOLAN
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:785-632-3115
Mailing Address - Street 1:422 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CLAY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67432-2908
Mailing Address - Country:US
Mailing Address - Phone:785-632-3115
Mailing Address - Fax:785-632-3777
Practice Address - Street 1:422 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CLAY CENTER
Practice Address - State:KS
Practice Address - Zip Code:67432-2908
Practice Address - Country:US
Practice Address - Phone:785-632-3115
Practice Address - Fax:785-632-3777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2-07255332B00000X, 332BX2000X
KS207255333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100435190BMedicaid
KS0000010362OtherBCBS OF KS DME
KSKA1546OtherMEDICARE PTAN: KA1546 - WPS
KS100435190AMedicaid
KS1701831OtherNCPDP
KS0000050410OtherBCBS OF KS PHARMACY
KS1821119306OtherNPI FOR DME
KS100435190BMedicaid