Provider Demographics
NPI:1578110540
Name:PRICE PHARMACIES INC
Entity Type:Organization
Organization Name:PRICE PHARMACIES INC
Other - Org Name:ANDOVER DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARED
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-221-0080
Mailing Address - Street 1:307 W HWY 54 STE 200
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-7849
Mailing Address - Country:US
Mailing Address - Phone:316-260-6030
Mailing Address - Fax:316-260-1019
Practice Address - Street 1:307 W HWY 54 STE 200
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:KS
Practice Address - Zip Code:67002-7849
Practice Address - Country:US
Practice Address - Phone:316-260-6030
Practice Address - Fax:316-260-1019
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRICE PHARMACIES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200674460EMedicaid
KS2-110340OtherKANSAS BOARD OF PHARMACY
KS2-110340OtherKANSAS BOARD OF PHARMACY