Provider Demographics
NPI:1821709130
Name:ASM PHARMACY-KANSAS, LLC
Entity Type:Organization
Organization Name:ASM PHARMACY-KANSAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-229-3301
Mailing Address - Street 1:224 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-4964
Mailing Address - Country:US
Mailing Address - Phone:402-753-2800
Mailing Address - Fax:
Practice Address - Street 1:800 ANN AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66101-3003
Practice Address - Country:US
Practice Address - Phone:913-573-5290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy