Provider Demographics
NPI:1477696540
Name:DILLON COMPANIES LLC
Entity type:Organization
Organization Name:DILLON COMPANIES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:WENDELL
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:WOOLF
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:513-762-4672
Mailing Address - Street 1:PO BOX 415000
Mailing Address - Street 2:MSC 410177 KING SOOPERS PHARMACY
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37241-5000
Mailing Address - Country:US
Mailing Address - Phone:866-680-5133
Mailing Address - Fax:620-669-1898
Practice Address - Street 1:2700 E 4TH AVE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501
Practice Address - Country:US
Practice Address - Phone:866-680-5133
Practice Address - Fax:620-669-1898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO510958Medicare PIN
CO511008Medicare PIN
CO544758Medicare PIN
CO546698Medicare PIN
CO510928Medicare PIN
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CO548778Medicare PIN
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CO546878Medicare PIN
CO511018Medicare PIN
CO544878Medicare PIN
CO510918Medicare PIN
CO510908Medicare PIN
CO510978Medicare PIN
CO546038Medicare PIN
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CO546358Medicare PIN
CO546778Medicare PIN
CO510948Medicare PIN