Provider Demographics
NPI:1689773590
Name:G & L PHARMACY, INC.
Entity Type:Organization
Organization Name:G & L PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:FLAX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-798-2897
Mailing Address - Street 1:207 S PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:NESS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67560-1909
Mailing Address - Country:US
Mailing Address - Phone:785-798-2897
Mailing Address - Fax:785-798-3267
Practice Address - Street 1:207 S PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:NESS CITY
Practice Address - State:KS
Practice Address - Zip Code:67560-1909
Practice Address - Country:US
Practice Address - Phone:785-798-2897
Practice Address - Fax:785-798-3267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS78643336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0460320001Medicare ID - Type Unspecified