Provider Demographics
NPI:1366459034
Name:MEDICAL CENTER PHARMACY INC
Entity Type:Organization
Organization Name:MEDICAL CENTER PHARMACY INC
Other - Org Name:DONS REXALL DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOOLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-983-2162
Mailing Address - Street 1:126 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:KS
Mailing Address - Zip Code:66866-1060
Mailing Address - Country:US
Mailing Address - Phone:620-983-2162
Mailing Address - Fax:620-983-2313
Practice Address - Street 1:126 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:KS
Practice Address - Zip Code:66866-1060
Practice Address - Country:US
Practice Address - Phone:620-983-2162
Practice Address - Fax:620-983-2313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2-076803336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2031319OtherPK
KS10043767013Medicaid
0210870003Medicare NSC