Provider Demographics
NPI:1831175637
Name:ROONEY, MARY A (RPH)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:ROONEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11390 W 359TH ST
Mailing Address - Street 2:
Mailing Address - City:PAOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66071-8106
Mailing Address - Country:US
Mailing Address - Phone:913-980-3329
Mailing Address - Fax:913-377-3325
Practice Address - Street 1:500 STATE HOSPITAL DRIVE
Practice Address - Street 2:OSAWATOMIE STATE HOSPITAL PHARMACY
Practice Address - City:OSAWATOMIE
Practice Address - State:KS
Practice Address - Zip Code:66071
Practice Address - Country:US
Practice Address - Phone:913-755-7215
Practice Address - Fax:913-755-7044
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS106781835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric