Provider Demographics
NPI:1811763378
Name:WILKARE PHARMACY OF DONIPHAN
Entity type:Organization
Organization Name:WILKARE PHARMACY OF DONIPHAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:870-351-0846
Mailing Address - Street 1:513 N GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:DONIPHAN
Mailing Address - State:MO
Mailing Address - Zip Code:63935-1405
Mailing Address - Country:US
Mailing Address - Phone:870-351-0846
Mailing Address - Fax:
Practice Address - Street 1:513 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:DONIPHAN
Practice Address - State:MO
Practice Address - Zip Code:63935-1405
Practice Address - Country:US
Practice Address - Phone:573-996-4127
Practice Address - Fax:573-996-5973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy