Organization Name: | CENTRE PHARMACY, INC. |
NPI Number: | 1699866202 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SAMUEL R. WAGNER (PIC OWNER,MGR.) |
Mailing Address: | 114 S Main St Smith Center |
State: | KS US |
Postal Code: | 669672606 |
Phone Number: | 7852826933 |
Fax Number: | 7852823550 |
NPI Enumeration Date: | 09/27/2006 |
NPI Last Update Date: | 06/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KS |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |