Provider Demographics
NPI:1689678450
Name:FOXX APOTHECARY, INC
Entity Type:Organization
Organization Name:FOXX APOTHECARY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:W. J.
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:FOXX
Authorized Official - Suffix:II
Authorized Official - Credentials:RPH
Authorized Official - Phone:620-223-5200
Mailing Address - Street 1:710 W,. 8TH ST.,
Mailing Address - Street 2:P.O. BOX 750
Mailing Address - City:FORT SCOTT
Mailing Address - State:KS
Mailing Address - Zip Code:66701-0750
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:710 W 8TH ST
Practice Address - Street 2:
Practice Address - City:FORT SCOTT
Practice Address - State:KS
Practice Address - Zip Code:66701-2404
Practice Address - Country:US
Practice Address - Phone:620-223-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6655333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0380880001Medicare ID - Type UnspecifiedMEDICARE