Provider Demographics
NPI:1528023199
Name:SENIOR CARE PHARMACY, INC.
Entity Type:Organization
Organization Name:SENIOR CARE PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:GERBER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:316-945-7455
Mailing Address - Street 1:8975 W MONROE CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-3321
Mailing Address - Country:US
Mailing Address - Phone:316-945-7455
Mailing Address - Fax:316-945-7457
Practice Address - Street 1:8975 W MONROE CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-3321
Practice Address - Country:US
Practice Address - Phone:316-945-7455
Practice Address - Fax:316-945-7457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2-100343336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy