Provider Demographics
NPI:1942215314
Name:MEDICAL CENTER PHARMACY INC
Entity Type:Organization
Organization Name:MEDICAL CENTER PHARMACY INC
Other - Org Name:MEDICAL CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:SCHOOLER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:620-241-0022
Mailing Address - Street 1:400 W 4TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MCPHERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67460-2306
Mailing Address - Country:US
Mailing Address - Phone:620-241-0022
Mailing Address - Fax:620-241-7805
Practice Address - Street 1:400 W 4TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460-2306
Practice Address - Country:US
Practice Address - Phone:620-241-0022
Practice Address - Fax:620-241-7805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2065503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100437690CMedicaid
1706603OtherNCPDP
KS0210870001Medicare NSC