Provider Demographics
NPI:1376133934
Name:NUMRICH, LOGAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LOGAN
Middle Name:
Last Name:NUMRICH
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 1:210 W MILL ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67663-2227
Mailing Address - Country:US
Mailing Address - Phone:785-434-4615
Mailing Address - Fax:785-434-4895
Practice Address - Street 1:210 W MILL ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:KS
Practice Address - Zip Code:67663-2227
Practice Address - Country:US
Practice Address - Phone:785-434-4615
Practice Address - Fax:785-434-4895
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-16790183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist