Healthcare Provider Details

I. General information

NPI: 1811389042
Provider Name (Legal Business Name): DANA MARIE CHENEY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2015
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S MILL ST
BELOIT KS
67420-3237
US

IV. Provider business mailing address

110 S MILL ST
BELOIT KS
67420-3237
US

V. Phone/Fax

Practice location:
  • Phone: 785-738-2285
  • Fax: 785-738-5144
Mailing address:
  • Phone: 785-738-2285
  • Fax: 785-738-5144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-13651
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: