Healthcare Provider Details
I. General information
NPI: 1649388745
Provider Name (Legal Business Name): LEONARD SCHMITZ & B & K PRESCRIPTION SHOP PTR
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/28/2006
Last Update Date: 10/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
204 N CEDAR ST
ABILENE KS
67410-2651
US
IV. Provider business mailing address
PO BOX 205
ABILENE KS
67410-0205
US
V. Phone/Fax
- Phone: 785-263-4550
- Fax: 785-263-1496
- Phone: 785-263-4550
- Fax: 785-263-1496
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | KS |
VIII. Authorized Official
Name:
LEONARD
SCHMITZ
Title or Position: OWNER/PIC
Credential:
Phone: 785-263-4550