Provider Demographics
NPI:1407872880
Name:LARMER, MICHAEL VANCE
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:VANCE
Last Name:LARMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701-2512
Mailing Address - Country:US
Mailing Address - Phone:785-460-3610
Mailing Address - Fax:
Practice Address - Street 1:460 N FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701-2326
Practice Address - Country:US
Practice Address - Phone:785-460-7507
Practice Address - Fax:785-460-2522
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-10981183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist