Provider Demographics
NPI:1770508681
Name:KATZER PHARMACY INC
Entity Type:Organization
Organization Name:KATZER PHARMACY INC
Other - Org Name:MEDICINE SHOPPE 1137
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:GALEMORE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:620-431-7193
Mailing Address - Street 1:421 W MAIN ST
Mailing Address - Street 2:PO BOX C
Mailing Address - City:CHANUTE
Mailing Address - State:KS
Mailing Address - Zip Code:66720-1607
Mailing Address - Country:US
Mailing Address - Phone:620-431-7193
Mailing Address - Fax:620-431-7741
Practice Address - Street 1:421 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CHANUTE
Practice Address - State:KS
Practice Address - Zip Code:66720-1607
Practice Address - Country:US
Practice Address - Phone:620-431-7193
Practice Address - Fax:620-431-7741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2-09517333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100443530AMedicaid
KS100443530BMedicaid