Provider Demographics
NPI:1316580269
Name:GOODLETT, MILKA (PHARM D)
Entity Type:Individual
Prefix:
First Name:MILKA
Middle Name:
Last Name:GOODLETT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:MILKA
Other - Middle Name:
Other - Last Name:ILIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1860 CLAFLIN RD
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-3413
Mailing Address - Country:US
Mailing Address - Phone:785-259-2934
Mailing Address - Fax:
Practice Address - Street 1:1860 CLAFLIN RD
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-3413
Practice Address - Country:US
Practice Address - Phone:785-776-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-15036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist