Provider Demographics
NPI:1649388745
Name:LEONARD SCHMITZ & B & K PRESCRIPTION SHOP PTR
Entity Type:Organization
Organization Name:LEONARD SCHMITZ & B & K PRESCRIPTION SHOP PTR
Other - Org Name:TRAPP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-263-4550
Mailing Address - Street 1:PO BOX 205
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:KS
Mailing Address - Zip Code:67410-0205
Mailing Address - Country:US
Mailing Address - Phone:785-263-4550
Mailing Address - Fax:785-263-1496
Practice Address - Street 1:204 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:KS
Practice Address - Zip Code:67410-2651
Practice Address - Country:US
Practice Address - Phone:785-263-4550
Practice Address - Fax:785-263-1496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
KS3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Multi-Specialty
No3336L0003XSuppliersPharmacyLong Term Care PharmacyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100080320AMedicaid