Provider Demographics
NPI:1932182664
Name:DANDURAND PHARMACY, INC
Entity Type:Organization
Organization Name:DANDURAND PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCCUNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-685-2353
Mailing Address - Street 1:7732 E CENTRAL AVE
Mailing Address - Street 2:#102 B
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2163
Mailing Address - Country:US
Mailing Address - Phone:316-685-2354
Mailing Address - Fax:316-685-5331
Practice Address - Street 1:625 N CARRIAGE PKWY STE 170
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-4519
Practice Address - Country:US
Practice Address - Phone:316-358-0303
Practice Address - Fax:316-685-1422
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANDURAND DRUG COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-28
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336L0003X
KS2-097083336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336S0011XSuppliersPharmacySpecialty Pharmacy