Provider Demographics
NPI:1801801444
Name:WEIMER DRUG CO., INC.
Entity type:Organization
Organization Name:WEIMER DRUG CO., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:NOLAN
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:785-632-3115
Mailing Address - Street 1:422 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CLAY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67432-2908
Mailing Address - Country:US
Mailing Address - Phone:785-632-3115
Mailing Address - Fax:785-632-3777
Practice Address - Street 1:204 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:KS
Practice Address - Zip Code:67455-1920
Practice Address - Country:US
Practice Address - Phone:785-524-4649
Practice Address - Fax:785-524-3402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2-099443336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200263600AMedicaid
2031106OtherPK
KS2002663600BMedicaid
5186670001Medicare NSC