Healthcare Provider Details

I. General information

NPI: 1063868883
Provider Name (Legal Business Name): TOURNESOL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 03/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 W 6TH ST
CONCORDIA KS
66901-2820
US

IV. Provider business mailing address

823 W 9TH ST
CONCORDIA KS
66901-3325
US

V. Phone/Fax

Practice location:
  • Phone: 785-614-3492
  • Fax: 785-340-3277
Mailing address:
  • Phone: 785-614-3492
  • Fax: 785-340-3277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number2-101620
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BRYAN BOMBARDIER
Title or Position: PHARMACIST
Credential:
Phone: 785-614-3492