Provider Demographics
NPI:1336219641
Name:TAYLOR DRUG OPERATING SERVICES INC
Entity Type:Organization
Organization Name:TAYLOR DRUG OPERATING SERVICES INC
Other - Org Name:TAYLOR DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/STORE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:620-442-3500
Mailing Address - Street 1:201 S SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-2846
Mailing Address - Country:US
Mailing Address - Phone:620-442-3500
Mailing Address - Fax:620-442-2184
Practice Address - Street 1:201 S SUMMIT ST
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-2846
Practice Address - Country:US
Practice Address - Phone:620-442-3500
Practice Address - Fax:620-442-2184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK99-360332B00000X
332BN1400X, 332BP3500X, 332BX2000X, 333600000X, 3336C0004X, 3336L0003X
KS2-066833336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100438430BMedicaid
2030514OtherPK
KS100438430AMedicaid
KS201087840AMedicaid
KS100063310AMedicaid
KS100438430BMedicaid