Provider Demographics
NPI:1659311306
Name:ALDRICH APOTHECARY CHARTERED
Entity Type:Organization
Organization Name:ALDRICH APOTHECARY CHARTERED
Other - Org Name:ALDRICH APOTHECARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:RZIHA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:620-767-6731
Mailing Address - Street 1:115 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COUNCIL GROVE
Mailing Address - State:KS
Mailing Address - Zip Code:66846-1702
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:115 W MAIN ST
Practice Address - Street 2:
Practice Address - City:COUNCIL GROVE
Practice Address - State:KS
Practice Address - Zip Code:66846-1702
Practice Address - Country:US
Practice Address - Phone:316-767-6800
Practice Address - Fax:620-767-6858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1037211333600000X
3336C0003X, 3336H0001X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Not Answered3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Not Answered3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1702023OtherOTHER ID NUMBER-COMMERCIAL NUMBER
03322001Medicare ID - Type Unspecified