Provider Demographics
NPI:1780645200
Name:BUNTING DUNLAP INC
Entity Type:Organization
Organization Name:BUNTING DUNLAP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHEAL
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:620-257-2821
Mailing Address - Street 1:114 W COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:KS
Mailing Address - Zip Code:67554-2718
Mailing Address - Country:US
Mailing Address - Phone:620-257-2821
Mailing Address - Fax:
Practice Address - Street 1:114 W COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:KS
Practice Address - Zip Code:67554-2718
Practice Address - Country:US
Practice Address - Phone:620-257-2821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8049333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy