Provider Demographics
NPI:1184901191
Name:CHANEY, PATRICK RYAN (PHARM D)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:RYAN
Last Name:CHANEY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13404 E TALLOWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67230-1766
Mailing Address - Country:US
Mailing Address - Phone:316-617-4650
Mailing Address - Fax:
Practice Address - Street 1:13404 E TALLOWOOD DR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67230-1766
Practice Address - Country:US
Practice Address - Phone:316-617-4650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-15261183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist