MEDICARE: PHARMACY ASSOCIATES OF DODGE CITY, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1134765399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMACY ASSOCIATES OF DODGE CITY, INC

Provider Business Mailing Address
First Line	:	2401 CENTRAL AVE
Second Line	:
City	:	DODGE CITY
State	:	KS
Zip	:	67801-6206
Country	:	US
Telephone Number	:	620-227-8193
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 CENTRAL AVE
Second Line	:
City	:	DODGE CITY
State	:	KS
Zip	:	67801-6206
Country	:	US
Telephone Number	:	620-227-8193
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	KRISTA MORRISON
Credential	:
Telephone Number	:	620-227-8193

Provider Enumeration Date	:	11/22/2019
Last Update Date	:	11/22/2019

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