Provider Demographics
NPI:1487659322
Name:KRIEN, KODY CHARLES (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KODY
Middle Name:CHARLES
Last Name:KRIEN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 664
Mailing Address - Street 2:
Mailing Address - City:ST FRANCIS
Mailing Address - State:KS
Mailing Address - Zip Code:67756-0664
Mailing Address - Country:US
Mailing Address - Phone:785-332-2177
Mailing Address - Fax:
Practice Address - Street 1:105 WEST WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:ST FRANCIS
Practice Address - State:KS
Practice Address - Zip Code:67756-0664
Practice Address - Country:US
Practice Address - Phone:785-332-2177
Practice Address - Fax:785-332-3555
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-12435183500000X
NE11442183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist