Provider Demographics
NPI:1013325950
Name:VOGTS, PENNY LYNN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PENNY
Middle Name:LYNN
Last Name:VOGTS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-2623
Mailing Address - Country:US
Mailing Address - Phone:620-232-3066
Mailing Address - Fax:620-231-5881
Practice Address - Street 1:2600 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-2623
Practice Address - Country:US
Practice Address - Phone:620-232-3066
Practice Address - Fax:620-231-5881
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS9376183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist